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Hoff G, Bernklev T, Johnsen L, Reitsma L, Sina D, Lauzike A, Gibbs C, Hoel Lende T, Narvestad JK, Kildahl R, Omdal R, Kvaløy JT, Søiland H. Thyroidectomy for Euthyroid Patients with Hashimoto Disease and Persistent Symptoms: An Observational, Postrandomization Study. J Thyroid Res 2024; 2024:5518720. [PMID: 38606313 PMCID: PMC11008973 DOI: 10.1155/2024/5518720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/06/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024] Open
Abstract
Background Despite adequate hormone substitution in Hashimoto disease, some patients may have persistent symptoms with a possible autoimmune pathophysiology. A recent randomized trial (RCT) using patient-reported outcome measures as the primary endpoint showed benefit in total thyroidectomy, but at a cost of high complication rates. Objective To verify results from the RCT in an observational study including a wider range of patients and explore means of predicting who may benefit from such surgery. Design A total of 154 patients with Hashimoto disease, euthyroid with or without thyroid hormone substitution, and persistent Hashimoto-related symptoms were subjected to total thyroidectomy and followed for 18 months after surgery. The primary outcome was the General Health (GH) dimensional score in the Short Form-36 Health Survey (SF-36). Results Eighteen months after surgery, a clinically significant improvement in GH was seen, similar to the findings in the previous RCT. Anti-TPO antibody titers were markedly reduced after surgery, but preoperative titers or other preoperative parameters could not predict the outcome of surgery. Three (1.9%) of 154 patients experienced permanent unilateral recurrent nerve palsy and six (3.9%) experienced hypoparathyroidism after surgery. Conclusions Thyroidectomy had a beneficial symptom-reducing effect in euthyroid patients with Hashimoto disease and persistent symptoms. The pathophysiology of residual symptoms remains unclear, and surgical complication rates are high. If thyroidectomy is considered as a treatment option, it should be performed in dedicated centers with experienced endocrine surgeons and as part of further studies on persistent symptoms. This trial is registered with NCT-02319538.
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Affiliation(s)
- Geir Hoff
- Department of Research, Telemark Hospital, Skien, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tomm Bernklev
- Department of Research, Vestfold Hospital, Tønsberg, Norway
| | - Lene Johnsen
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Laurens Reitsma
- Department of Breast and Endocrine Surgery, Akershus University Hospital, Campus Oslo, Lørenskog, Norway
| | - Dirk Sina
- Department of Breast and Endocrine Surgery, Telemark Hospital, Skien, Norway
| | - Andromeda Lauzike
- Department of Breast and Endocrine Surgery, Telemark Hospital, Skien, Norway
| | | | - Tone Hoel Lende
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Jon Kristian Narvestad
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | | | - Roald Omdal
- Department of Research, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Jan Terje Kvaløy
- Department of Research, Stavanger University Hospital, Stavanger, Norway
- Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway
| | - Håvard Søiland
- Department of Research, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
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Lukina P, Andersen IL, Eggen PT, Mjønes PG, Rønne E, Bolstad N, Klaasen RA, Warren DJ, Iversen R, Hveem K, Bernklev T, Jelsness-Jørgensen LP, Pedersen L, Jonkers I, Lagergren P, Sollid LM, Lundin K, Ness-Jensen E. Coeliac disease in the Trøndelag Health Study (HUNT), Norway, a population-based cohort of coeliac disease patients. BMJ Open 2024; 14:e077131. [PMID: 38195172 PMCID: PMC10806793 DOI: 10.1136/bmjopen-2023-077131] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/09/2023] [Indexed: 01/11/2024] Open
Abstract
PURPOSE Coeliac disease (CD) is a common disorder and affects about 1% of the population worldwide. CD in the Trøndelag Health Study (HUNT) is a population-based cohort study which was established to provide new knowledge about CD that can improve the diagnostics and management, prevent the onset or progression and expand the knowledge about the role of genetics of the disease. PARTICIPANTS The cohort is based on the fourth wave of the population-based HUNT study (HUNT4), Norway, performed during 2017-2019, also including linkage to hospital records and the Norwegian Patient Registry (NPR). A total of 54 541 HUNT4 participants with available sera were screened for CD by serology. All seropositive participants were invited to a clinical assessment, including endoscopy with duodenal biopsies, during 2019-2023. FINDINGS TO DATE A total of 1107 HUNT4 participants (2%) were seropositive for CD and 1048 were eligible for clinical assessment, including biopsy. Of these, 724 participants attended the clinical assessment and 482 were identified with CD. In addition, 371 participants with CD were identified through the hospital records and NPR. In total, 853 participants in HUNT4 with biopsy-verified CD diagnosis were identified. FUTURE PLANS All participants in the study will be invited to a follow-up assessment after at least 1 year, including repeated standard serological testing, endoscopy and tissue sampling. The collected data and material will be used to establish the true population-based prevalence of CD. The consequences of CD, including symptoms, deficiencies and comorbidity, will be investigated and possible triggers and predictors, will be studied. With access to serum samples from the previous HUNT surveys in HUNT Biobank, serological signs of CD in prediagnostic samples of seropositive individuals will be used. Genetic studies will identify new CD markers, assess genotype-phenotype links and explore gene-environment correlations. REGISTRATION clinicaltrials.gov identifier: NCT04041622.
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Affiliation(s)
- Polina Lukina
- HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway
| | - Ina Lervåg Andersen
- HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Petter Tinbod Eggen
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Patricia Gjertrud Mjønes
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway
- Department of Pathology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Trøndelag, Norway
| | - Elin Rønne
- Department of Pathology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Trøndelag, Norway
| | - Nils Bolstad
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Rolf Anton Klaasen
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - David J Warren
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Rasmus Iversen
- K.G. Jebsen Centre for Coeliac Disease Research, University of Oslo, Oslo, Norway
| | - Kristian Hveem
- HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway
- K.G. Jebsen Centre for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- R&D Department, Vestfold Hospital Trust, Tønsberg, Vestfold, Norway
| | - Lars Petter Jelsness-Jørgensen
- Østfold University College, Halden, Østfold, Norway
- Department of Gastroenterology, Østfold Hospital Trust, Kalnes, Norway
| | | | - Iris Jonkers
- Department of Genetics, University of Groningen, Groningen, Groningen, The Netherlands
| | - Pernilla Lagergren
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Stockholm, Sweden
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Ludvig Magne Sollid
- K.G. Jebsen Centre for Coeliac Disease Research, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Knut Lundin
- K.G. Jebsen Centre for Coeliac Disease Research, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Eivind Ness-Jensen
- HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Stockholm, Sweden
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Hoff G, Bernklev T, Johnsen L, Reitsma L, Sina D, Lauzike A, Gibbs C, Carlsen E, Lende TH, Narvestad JK, Kildahl R, Omdal R, Kvaløy JT, Søiland H. Thyroidectomy for Euthyroid Patients With Hashimoto Disease and Persisting Symptoms. Ann Intern Med 2024; 177:101-103. [PMID: 38011703 DOI: 10.7326/m23-1593] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Affiliation(s)
- Geir Hoff
- Department of Research, Telemark Hospital, Skien, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, Oslo, and Department of Research, Vestfold Hospital, Tønsberg, Norway
| | - Lene Johnsen
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Laurens Reitsma
- Department of Breast and Endocrine Surgery, Akershus University Hospital, Campus Oslo, Lørenskog, Norway
| | - Dirk Sina
- Department of Breast and Endocrine Surgery, Telemark Hospital, Skien, Norway
| | - Andromeda Lauzike
- Department of Breast and Endocrine Surgery, Telemark Hospital, Skien, Norway
| | | | - Eivind Carlsen
- Department of Pathology, Telemark Hospital Skien, Norway
| | - Tone Hoel Lende
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Jon Kristian Narvestad
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | | | - Roald Omdal
- Department of Research, Stavanger University Hospital, Stavanger, and Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Jan Terje Kvaløy
- Department of Research, Stavanger University Hospital, and Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway
| | - Håvard Søiland
- Department of Research, Stavanger University Hospital, Stavanger, and Department of Clinical Science, University of Bergen, Bergen, Norway
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Holten KIA, Bernklev T, Opheim R, Johansen I, Olsen BC, Lund C, Strande V, Medhus AW, Perminow G, Bengtson MB, Cetinkaya RB, Vatn S, Frigstad SO, Aabrekk TB, Detlie TE, Hovde Ø, Kristensen VA, Småstuen MC, Henriksen M, Huppertz-Hauss G, Høivik ML, Jelsness-Jørgensen LP. Fatigue in Patients with Newly Diagnosed Inflammatory Bowel Disease: Results from a Prospective Inception Cohort, the IBSEN III Study. J Crohns Colitis 2023; 17:1781-1790. [PMID: 37279652 PMCID: PMC10673818 DOI: 10.1093/ecco-jcc/jjad094] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/11/2023] [Accepted: 06/02/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND AIMS Although fatigue is common in inflammatory bowel disease [IBD], its pathogenesis remains unclear. This study aimed to determine the prevalence of fatigue and its associated factors in a cohort of patients newly diagnosed with IBD. METHODS Patients ≥18 years old were recruited from the Inflammatory Bowel Disease South-Eastern Norway [IBSEN III] study, a population-based, observational inception cohort. Fatigue was assessed using the Fatigue Questionnaire and compared with data from a Norwegian general population. Univariate and multivariate linear and logistic regression analyses were performed to evaluate the associations of total fatigue [TF; continuous score] and substantial fatigue [SF; dichotomized score ≥4] with sociodemographic, clinical, endoscopic, laboratory, and other relevant patient data. RESULTS In total, 983/1509 [65.1%] patients with complete fatigue data were included (ulcerative colitis [UC], 68.2%; Crohn's disease [CD], 31.8%). The prevalence of SF was higher in CD [69.6%] compared with UC [60.2%] [p < 0.01], and in both diagnoses when compared to the general population [p < 0.001]. In multivariate analyses, depressive symptoms, pain intensity, and sleep disturbances were associated with increased TF for both diagnoses. In addition, increased clinical disease activity and Mayo endoscopic score were significantly associated with TF in UC, whereas all disease-related variables were insignificant in CD. Similar findings were observed for SF, except regarding the Mayo endoscopic score. CONCLUSIONS SF affects approximately two-thirds of patients newly diagnosed with IBD. Fatigue was associated with depressive symptoms, sleep disturbances, and increased pain intensity in both diagnoses, while clinical and endoscopic activity were associated factors only in UC.
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Affiliation(s)
- Kristina I Aass Holten
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Østfold Hospital Trust, Sarpsborg, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Research and Development Department, Vestfold Hospital Trust, Tønsberg, Norway
| | - Randi Opheim
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingunn Johansen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Health Sciences, Østfold University College, Halden, Norway
| | - Bjørn C Olsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Telemark Hospital Trust, Skien, Norway
| | - Charlotte Lund
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Vibeke Strande
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Gastroenterology, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Asle W Medhus
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Gøri Perminow
- Pediatric Department, Oslo University Hospital, Oslo, Norway
| | | | | | - Simen Vatn
- Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway
| | | | - Tone B Aabrekk
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Vestfold Hospital Trust, Tønsberg, Norway
| | - Trond Espen Detlie
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway
| | - Øistein Hovde
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Innlandet Hospital Trust, Gjøvik, Norway
| | | | | | - Magne Henriksen
- Department of Gastroenterology, Østfold Hospital Trust, Sarpsborg, Norway
| | | | - Marte Lie Høivik
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Lars-Petter Jelsness-Jørgensen
- Department of Gastroenterology, Østfold Hospital Trust, Sarpsborg, Norway
- Department of Health Sciences, Østfold University College, Halden, Norway
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5
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Olsen BC, Opheim R, Kristensen VA, Høivik ML, Lund C, Aabrekk TB, Johansen I, Holten K, Strande V, Bengtson MB, Ricanek P, Detlie TE, Bernklev T, Jelsness-Jørgensen LP, Huppertz-Hauss G. Health-related quality of life in patients with newly diagnosed inflammatory bowel disease: an observational prospective cohort study (IBSEN III). Qual Life Res 2023; 32:2951-2964. [PMID: 37219727 PMCID: PMC10473983 DOI: 10.1007/s11136-023-03435-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE This unselected, population-based cohort study aimed to determine the level of health-related quality of life (HRQoL) in patients with Crohn's disease (CD) and ulcerative colitis (UC) at the time of diagnosis compared with a reference population and identify the demographic factors, psychosocial measures, and disease activity markers associated with HRQoL. METHODS Adult patients newly diagnosed with CD or UC were prospectively enrolled. HRQoL was measured using the Short Form 36 (SF-36) and Norwegian Inflammatory Bowel Disease Questionnaires. Clinical significance was assessed using Cohen's d effect size and further compared with a Norwegian reference population. Associations between HRQoL and symptom scores, demographic factors, psychosocial measures, and disease activity markers were analyzed. RESULTS Compared with the Norwegian reference population, patients with CD and UC reported significantly lower scores in all SF-36 dimensions, except for physical functioning. Cohen's d effect sizes for men and women in all SF-36 dimensions were at least moderate, except for bodily pain and emotional role for men with UC and physical functioning for both sexes and diagnoses. In the multivariate regression analysis, depression subscale scores ≥ 8 on the Hospital Anxiety and Depression Scale, substantial fatigue, and high symptom scores were associated with reduced HRQoL. CONCLUSION Patients newly diagnosed with CD and UC reported statistically and clinically significantly lower scores in seven of the eight SF-36 dimensions than the reference population. Symptoms of depression, fatigue, and elevated symptom scores were associated with poorer HRQoL.
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Affiliation(s)
- Bjorn Christian Olsen
- Department of Gastroenterology, Skien Hospital, Telemark Hospital Trust, Ulefossvegen 55, 3710, Skien, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Randi Opheim
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Vendel A Kristensen
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Marte Lie Høivik
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Charlotte Lund
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Tone Bergene Aabrekk
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Vestfold Hospital Trust, Research and Development, Tønsberg, Norway
| | - Ingunn Johansen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Faculty of Health, Welfare and Organisation, Østfold University College, Halden, Norway
| | - Kristina Holten
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Østfold Hospital Trust, Sarpsborg, Norway
| | - Vibeke Strande
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | | | - Petr Ricanek
- Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway
| | - Trond Espen Detlie
- Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Vestfold Hospital Trust, Research and Development, Tønsberg, Norway
| | - Lars-Petter Jelsness-Jørgensen
- Faculty of Health, Welfare and Organisation, Østfold University College, Halden, Norway
- Department of Gastroenterology, Østfold Hospital Trust, Sarpsborg, Norway
| | - Gert Huppertz-Hauss
- Department of Gastroenterology, Skien Hospital, Telemark Hospital Trust, Ulefossvegen 55, 3710, Skien, Norway
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Kirkøen B, Berstad P, Hoff G, Bernklev T, Randel KR, Holme Ø, de Lange T, Robb KA, Botteri E. Type and Severity of Mental Illness and Participation in Colorectal Cancer Screening. Am J Prev Med 2023; 64:76-85. [PMID: 36216655 DOI: 10.1016/j.amepre.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The effectiveness of colorectal cancer screening programs depends on the participation rate. This study examined the association between type and severity of mental illness and colorectal cancer screening participation. METHODS Between 2012 and 2017, a total of 46,919 individuals were invited to sigmoidoscopy screening in Norway, and 70,019 were invited to fecal immunochemical testing. In 2022, logistic regression was used to evaluate the association between the use of antipsychotics, anxiolytics, hypnotics, and antidepressants in the year preceding the screening invitation and screening participation, adjusted for demographic and socioeconomic factors. Defined daily doses of individual drugs were used to assess dose‒response relationships. RESULTS Overall, 19.2% (24.8% of women, 13.4% of men) of all invitees used at least 1 psychotropic medication. Nonparticipation in the 2 arms combined was associated with the use of anxiolytics (60.7% in users vs 43.2% in nonusers; OR=1.53; 95% CI=1.45, 1.62) and antipsychotics (64.3% vs 43.8%; OR=1.41; 95% CI=1.30, 1.53) and increased with higher doses for both drugs. Hypnotics and antidepressants were only weakly associated with nonparticipation in higher doses. Participation rates were 57.3%, 52.3%, 42.9%, and 35.4% in those prescribed 0, 1, 2, and 3-4 classes of psychotropic medications, respectively. The associations between the use of psychotropic medications and nonparticipation were similar for the 2 screening tests. CONCLUSIONS These findings show significant disparities in colorectal cancer screening participation for individuals with mental illness, independent of the screening method. Moreover, screening participation varied depending on the type and severity of mental illness. Targeted interventions are warranted to ensure that people with mental illness are supported to access the benefits of colorectal cancer screening.
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Affiliation(s)
- Benedicte Kirkøen
- From the Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway; Regional Center for Child and Adolescent Mental Health (RBUP), Oslo, Norway.
| | - Paula Berstad
- From the Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Geir Hoff
- From the Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway; Department of Research and Development, Telemark Hospital Trust, Skien, Norway; Institute of Clinical Medicine, University of Oslo Oslo, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo Oslo, Norway; Department of Research and Development, Vestfold Hospital Trust, Tønsberg, Norway
| | - Kristin R Randel
- From the Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Øyvind Holme
- Department of medicine, Sørlandet Hospital, Kristiansand, Norway; Institute of Health & Society, University of Oslo, Oslo, Norway
| | - Thomas de Lange
- Department of Medicine, Sahlgrenska University Hospital-Mölndal, Region Västra Götaland, Sweden; Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Medical Research, Bærum Hospital, Gjettum, Norway
| | - Kathryn A Robb
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Edoardo Botteri
- From the Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway; and the Department of Research, Cancer Registry of Norway, Oslo, Norway
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Tsarpali V, Midtvedt K, Lønning K, Bernklev T, Åsberg A, Von der Lippe N, Varberg Reisater A, Heldal K. FC 111: A Comorbidity Index and Pretransplant Physical Status Predict Survival in Older Kidney Transplant Recipients. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac122.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Regardless of age, kidney transplantation (KT) is considered the optimal treatment for patients with end-stage kidney disease (ESKD). In the increasing elderly ESKD population, KT should be reserved for carefully selected candidates who are expected to experience favorable outcomes. We aimed to prospectively evaluate pre-transplant recipient factors that may predict post-transplant patient survival and can eventually guide therapeutic decisions in elderly with ESKD.
METHOD
Recipient factors were evaluated in KT candidates aged ≥65 years, who were enlisted for KT between January 2013 and November 2016 at the Norwegian national transplant centre. Pretransplant comorbidity was assessed at waitlisting, according to the Liu Comorbidity Index (LCI). Self-reported health-related quality of life was assessed using the Kidney Disease Quality of Life Short Form version 1.3 (KDQOL-SF). The Cox proportional hazard regression was used to evaluate predictors of patient survival.
RESULTS
We included 289 waitlisted candidates, of whom 192 received a deceased brain-dead donor kidney. Mean age at KT was 72 (4.1) years, 133 (69%) were male, 47 (24%) were transplanted preemptively and 80% received an expanded criteria donor organ. During a median observation time of 4.6 (3.2–6.3) years post-KT, 66 recipients died. LCI ≤ 3 was observed in 136 recipients (71%), between 4–6 in 39 recipients (20%) and 17 recipients (9%) had LCI ≥ 7. Elevated LCI ≥ 4 predicted poor patient survival, and was associated with a 2.2-times increase in mortality risk (Figure 1). In recipients with LCI ≥ 4, dialysis ≥2 years comprised a 2.5-fold higher mortality risk, compared with recipients on dialysis ≤2 years (Figure 2). Self-reported pretransplant physical function was also proven to be a significant positive predictor of survival, with scores ≤60 being associated with a 2-fold increase in mortality risk.
CONCLUSION
The implementation of LCI and a physical function score during the evaluation of older kidney transplant candidates may improve the selection and thereby optimize post-transplant outcomes.
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Affiliation(s)
- Vasiliki Tsarpali
- Clinic of Internal Medicine, Telemark Hospital Trust, Skien, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Karsten Midtvedt
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Kjersti Lønning
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Tomm Bernklev
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Research and Innovation, Vestfold Hospital Trust, Tønsberg, Norway
| | - Anders Åsberg
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Nanna Von der Lippe
- Department of Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Anna Varberg Reisater
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Kristian Heldal
- Clinic of Internal Medicine, Telemark Hospital Trust, Skien, Norway
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
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Tsarpali V, Midtvedt K, Lønning K, Bernklev T, Åsberg A, Von der Lippe N, Varberg Reisater A, Heldal K. MO985: Physical Function Trajectories Predict Patient Survival in Older Recipients of Deceased Donor Kidneys. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac087.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Health-related quality of life (HRQOL) outcomes have been positively associated with patient survival after kidney transplantation (KT). In older recipients, poor HRQOL may indicate risk for clinical deterioration. We aimed to prospectively evaluate if, in older recipients of deceased brain-dead donor (DBD) kidneys, changes in HRQOL during the first year post-transplantation differed between survivor and non-survivors.
METHOD
KT candidates aged ≥65 years who were enlisted between January 2013 and November 2016 at the Norwegian national transplant center and received a deceased brain-dead donor (DBD) kidney were included. HRQOL was assessed using the Kidney Disease Quality of Life Short Form, version 1.3. HRQOL outcomes were collected prior to KT, at 10 weeks, 6 months and 12 months post-KT. A mixed-effect linear regression model was used to examine the development of HRQOL during the first year post-KT in survivors versus non-survivors. Longitudinal HRQOL trajectories were identified using a group-based trajectory modelling. A Cox proportional hazard regression was used to investigate the association of longitudinal HRQOL trajectories for each domain with patient survival.
RESULTS
We included 289 waitlisted candidates, of whom 192 received a DBD kidney. Mean age at KT was 72 (4.1) years, 133 (69%) were males, 47 (24%) were transplanted preemptively and 80% received an expanded criteria donor organ. During a median observation time of 4.6 (3.2, 6.3) years post-KT, 66 recipients died. In survivors, all the generic and kidney-specific HRQOL domains substantially improved during the first year post-KT, whereas HRQOL deteriorated in non-survivors (Figure 1). Three developmental trajectories, describing poor, fair and good outcomes were identified for most of the HRQOL domains. Recipients perceiving poor physical development during the first post-transplant year had a 2.5 higher mortality risk, while recipients with fair physical development had 1.4 increased mortality risk, compared with recipients with good physically development (Figure 2).
CONCLUSION
In elderly kidney transplant recipients, poor post-transplant physical function trajectory may indicate impaired survival. The systematic HRQOL monitoring following KT is warranted to identify high-risk patients and guide therapeutic decisions.
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Affiliation(s)
- Vasiliki Tsarpali
- Telemark Hospital Trust, Clinic of Internal Medicine, Skien, Norway
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
- Oslo University Hospital, Department of Transplantation Medicine, Section of Nephrology, Oslo, Norway
| | - Karsten Midtvedt
- Oslo University Hospital, Department of Transplantation Medicine, Section of Nephrology, Oslo, Norway
| | - Kjersti Lønning
- Oslo University Hospital, Department of Transplantation Medicine, Section of Nephrology, Oslo, Norway
| | - Tomm Bernklev
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
- Vestfold Hospital Trust, Department of Research and Innovation, Tønsberg, Norway
| | - Anders Åsberg
- Oslo University Hospital, Department of Transplantation Medicine, Section of Nephrology, Oslo, Norway
- University of Oslo, Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, Oslo, Norway
| | - Nanna Von der Lippe
- Oslo University Hospital, Department of Medicine, Section of Nephrology, Oslo, Norway
| | - Anna Varberg Reisater
- Oslo University Hospital, Department of Transplantation Medicine, Section of Nephrology, Oslo, Norway
| | - Kristian Heldal
- Telemark Hospital Trust, Clinic of Internal Medicine, Skien, Norway
- Oslo University Hospital, Department of Transplantation Medicine, Section of Nephrology, Oslo, Norway
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9
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Søiland H, Janssen EAM, Helland T, Eliassen FM, Hagland M, Nordgård O, Lunde S, Lende TH, Sagen JV, Tjensvoll K, Gilje B, Jonsdottir K, Gudlaugsson E, Lode K, Hagen KB, Gripsrud BH, Lind R, Heie A, Aas T, Austdal M, Egeland NG, Bernklev T, Lash TL, Skartveit L, Kroksveen AC, Oltedal S, Kvaløy JT, Lien EA, Sleire L, Mellgren G. Liquid biopsies and patient-reported outcome measures for integrative monitoring of patients with early-stage breast cancer: a study protocol for the longitudinal observational Prospective Breast Cancer Biobanking (PBCB) study. BMJ Open 2022; 12:e054404. [PMID: 35487718 PMCID: PMC9058781 DOI: 10.1136/bmjopen-2021-054404] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Breast cancer is still the most common malignancy among women worldwide. The Prospective Breast Cancer Biobank (PBCB) collects blood and urine from patients with breast cancer every 6 or 12 months for 11 years from 2011 to 2030 at two university hospitals in Western Norway. The project aims to identify new biomarkers that enable detection of systemic recurrences at the molecular level. As blood represents the biological interface between the primary tumour, the microenvironment and distant metastases, liquid biopsies represent the ideal medium to monitor the patient's cancer biology for identification of patients at high risk of relapse and for early detection systemic relapse.Including patient-reported outcome measures (PROMs) allows for a vast number of possibilities to compare PROM data with biological information, enabling the study of fatigue and Quality of Life in patients with breast cancer. METHODS AND ANALYSIS A total of 1455 patients with early-stage breast cancer are enrolled in the PBCB study, which has a one-armed prospective observational design. Participants consent to contribute liquid biopsies (i.e., peripheral blood and urine samples) every 6 or 12 months for 11 years. The liquid biopsies are the basis for detection of circulating tumour cells, circulating tumour DNA (ctDNA), exosomal micro-RNA (miRNA), miRNA in Tumour Educated Platelet and metabolomic profiles. In addition, participants respond to 10 PROM questionnaires collected annually. Moreover, a control group comprising 200 women without cancer aged 25-70 years will provide the same data. ETHICS AND DISSEMINATION The general research biobank PBCB was approved by the Ministry of Health and Care Services in 2007, by the Regional Ethics Committee (REK) in 2010 (#2010/1957). The PROM (#2011/2161) and the biomarker study PerMoBreCan (#2015/2010) were approved by REK in 2011 and 2015 respectively. Results will be published in international peer reviewed journals. Deidentified data will be accessible on request. TRIAL REGISTRATION NUMBER NCT04488614.
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Affiliation(s)
- Håvard Søiland
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Emiel A M Janssen
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
- Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger, Norway
| | - Thomas Helland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Finn Magnus Eliassen
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Magnus Hagland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Oddmund Nordgård
- Department of Hematology and Oncology, Stavanger University Hospital, Stavanger, Norway
- Department of Chemistry, Bioscience, University of Stavanger, Stavanger, Norway
| | - Siri Lunde
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Tone Hoel Lende
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Jørn Vegard Sagen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Kjersti Tjensvoll
- Department of Hematology and Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Bjørnar Gilje
- Department of Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Kristin Jonsdottir
- Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Einar Gudlaugsson
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
| | - Kirsten Lode
- Department of Research, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences Department of Caring and Ethics, University of Stavanger, Stavanger, Norway
| | - Kari Britt Hagen
- Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway
| | - Birgitta Haga Gripsrud
- Faculty of Health Sciences Department of Caring and Ethics, University of Stavanger, Stavanger, Norway
| | - Ragna Lind
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Anette Heie
- Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway
| | - Turid Aas
- Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway
| | - Marie Austdal
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
- Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Nina Gran Egeland
- Department of Breast and Endocrine Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Tomm Bernklev
- Central Hospital in Vestfold, Tønsberg, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Timothy L Lash
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Linn Skartveit
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | | | - Satu Oltedal
- Department of Hematology and Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Jan Terje Kvaløy
- Department of Research, Stavanger University Hospital, Stavanger, Norway
- Mathematics and Physics, Department of Mathematics and Natural Science, University of Stavanger, Stavanger, Norway
| | - Ernst A Lien
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Linda Sleire
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Gunnar Mellgren
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Laboratory Medicine and Pathology, Haukeland University Hospital, Bergen, Norway
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10
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Botteri E, Hoff G, Randel KR, Holme Ø, de Lange T, Bernklev T, Aas E, Berthelsen M, Natvig E, Kirkøen B, Knudsen MD, Kvaerner AS, Schult AL, Ursin G, Jørgensen A, Berstad P. Characteristics of non-participants in a randomized colorectal cancer screening trial comparing sigmoidoscopy and faecal immunochemical testing. Int J Cancer 2022; 151:361-371. [PMID: 35411554 PMCID: PMC9324830 DOI: 10.1002/ijc.34025] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/23/2022] [Accepted: 04/01/2022] [Indexed: 11/11/2022]
Abstract
Public health systems should guarantee universal access to health care services, including cancer screening. We assessed whether certain population subgroups were underrepresented among participants in colorectal cancer screening with sigmoidoscopy and faecal immunochemical testing (FIT). Between 2012 and 2019, about 140 000 individuals aged 50 to 74 years were randomly invited to once‐only sigmoidoscopy or first round of FIT screening. Our study included 46 919 individuals invited to sigmoidoscopy and 70 019 to FIT between 2012 and 2017. We used logistic regression models to evaluate if demographic and socioeconomic factors and use of certain drugs were associated with participation. Twenty‐four thousand one hundred and fifty‐nine (51.5%) individuals attended sigmoidoscopy and 40 931 (58.5%) FIT screening. Male gender, young age, low education and income, being retired or unemployed, living alone, being an immigrant, long driving time to screening centre, and use of antidiabetic and psychotropic drugs were associated with low participation in both screening groups. Many of these factors also predicted low acceptance of colonoscopy after positive FIT. While male gender, young age and living alone were more strongly associated with nonparticipation in FIT than sigmoidoscopy, low education and income, being retired or immigrant and long driving time were more strongly associated with nonparticipation in sigmoidoscopy than FIT. In conclusion, participation was lower in sigmoidoscopy than FIT. Predictors of nonparticipation were similar between arms. However, low socioeconomic status, being an immigrant and long driving time affected participation more in sigmoidoscopy screening, suggesting that FIT may guarantee more equal access to screening services than sigmoidoscopy.
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Affiliation(s)
- Edoardo Botteri
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.,Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Geir Hoff
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.,Department of Research and Development, Telemark Hospital Trust, Skien, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristin R Randel
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Øyvind Holme
- Department of Medicine, Sørlandet Hospital, Kristiansand, Norway.,Institute for Health and Society, University of Oslo, Oslo, Norway
| | - Thomas de Lange
- Department of Medicine, Sahlgrenska University Hospital- Mölndal, Region Västra Götaland, Sweden.,Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.,Department of Medical Research, Baerum Hospital, Gjettum, Norway
| | - Tomm Bernklev
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Research and Innovation, Vestfold Hospital, Tønsberg, Norway
| | - Eline Aas
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| | - Mona Berthelsen
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Erik Natvig
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Benedicte Kirkøen
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.,Regional Center for Child and Adolescent Mental Health (RBUP), Oslo, Norway
| | - Markus D Knudsen
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.,Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Norwegian PSC Research Center, Oslo University Hospital, Oslo, Norway.,Departments of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ane S Kvaerner
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Anna L Schult
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Medical Research, Baerum Hospital, Gjettum, Norway
| | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Anita Jørgensen
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Paula Berstad
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
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11
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Berge J, Hjelmesæth J, Kolotkin RL, Støren Ø, Bratland-Sanda S, Hertel JK, Gjevestad E, Småstuen MC, Helgerud J, Bernklev T. Effect of aerobic exercise intensity on health-related quality of life in severe obesity: a randomized controlled trial. Health Qual Life Outcomes 2022; 20:34. [PMID: 35209911 PMCID: PMC8876087 DOI: 10.1186/s12955-022-01940-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/15/2022] [Indexed: 12/05/2022] Open
Abstract
Background Aerobic exercise is an important part of obesity treatment and may improve health-related quality of life (HRQOL). The objective of this study was to compare the effect of two different exercise programs on health-related quality of life in patients with severe obesity. Methods This was a single-center, open-label, randomized, parallel-group study comparing the effects of a 24-week moderate-intensity continuous training (MICT) program and a combined high-intensity interval training program with MICT (HIIT/MICT). The primary objective (specified secondary outcome) was to assess HRQOL by using the general health dimension of the Short Form Health Survey (SF-36). The secondary objectives were to assess other dimensional SF-36 scores, the impact of weight on the physical and psychosocial aspects of quality of life (IWQOL-Lite), and the burden of obesity-specific weight symptoms (WRSM). Results 73 patients were enrolled and reported patient reported outcome measures, with 71 patients (55% females) allocated to either MICT (n = 34) or HIIT/MICT (n = 37). In the intention-to-treat analysis, general health scores increased between baseline and 24-week follow-up in both the HIIT/MICT group and the MICT group, with a mean change of 13 (95% CI 6–21) points and 11 (95% CI 5–17) points, respectively, with no difference between the groups. The effect sizes of these changes were moderate. The vitality and social functioning scores of SF-36, and the physical function and self-esteem scores of IWQOL-Lite increased moderately in both groups, with no difference between groups. The tiredness, back pain, and physical stamina scores based on WRSM showed moderate to strong changes in both the groups. Conclusions Patients who had completed a combined HIIT/MICT program did not experience larger improvements in general health compared with those completing a clean 24-week MICT program. Exercise may confer general health benefits independent of intensity. Trials registration Regional Committees for Medical and Health Research Ethics south east, Norway, October 23, 2013 (identifier: 2013/1849) and ClinicalTrials.gov December 8, 2014 (identifier: NCT02311738). Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-01940-y.
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Affiliation(s)
- Jarle Berge
- Morbid Obesity Centre, Vestfold Hospital Trust, Box 2168, 3103, Tønsberg, Norway. .,Clinic of Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway. .,Nature, Health and Environment, University of South-Eastern Norway, Bø, Norway. .,Norwegian Police University College, Stavern, Norway.
| | - Jøran Hjelmesæth
- Morbid Obesity Centre, Vestfold Hospital Trust, Box 2168, 3103, Tønsberg, Norway.,Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ronette L Kolotkin
- Morbid Obesity Centre, Vestfold Hospital Trust, Box 2168, 3103, Tønsberg, Norway.,Quality of Life Consulting, Durham, NC, USA.,Department of Family Medicine and Community Health, Duke University Medical Center, Durham, NC, USA.,Førde Hospital Trust, Førde, Norway
| | - Øyvind Støren
- Nature, Health and Environment, University of South-Eastern Norway, Bø, Norway.,Department of Sport, Physical Education and Outdoor Life Studies, University of South-Eastern Norway, Bø, Norway
| | - Solfrid Bratland-Sanda
- Department of Sport, Physical Education and Outdoor Life Studies, University of South-Eastern Norway, Bø, Norway
| | | | - Espen Gjevestad
- Clinic of Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway.,Norwegian Police University College, Stavern, Norway
| | | | - Jan Helgerud
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway.,Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway
| | - Tomm Bernklev
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.,R&D Department, Vestfold Hospital Trust, Tønsberg, Norway
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12
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Jelsness-Jørgensen LP, Moum B, Grimstad T, Jahnsen J, Hovde Ø, Frigstad SO, Bernklev T. The multidimensional fatigue inventory (MFI-20): psychometrical testing in a Norwegian sample of inflammatory bowel disease (IBD) patients. Scand J Gastroenterol 2022:1-7. [PMID: 35076321 DOI: 10.1080/00365521.2022.2029939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/02/2022] [Accepted: 01/11/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To evaluate the psychometric properties of the Norwegian version of the multidimensional fatigue inventory (MFI-20) in patients with inflammatory bowel disease. METHODS Participants were recruited from nine hospitals in the southeastern and western parts of Norway. Clinical and sociodemographic data were collected, and participants completed the MFI-20, as well as the Fatigue Questionnaire (FQ). In addition to a confirmatory factor analysis, validity, reliability, test-retest and responsiveness were evaluated. RESULTS In total, 410 patients were included. The Norwegian MFI-20 had an acceptable model fit when compared to the original five-dimensional structure. A positive correlation was observed between the dimensions of MFI-20 and the FQ. MFI-20 scores increased according to subjective disease activity, but no differences were observed when using a calprotectin cut-off < or > =250 µg/g mg/kg. All MFI-20 dimensions except 'reduced motivation' in both ulcerative colitis (UC) and Crohn's disease (CD) patients had alpha Cronbach alpha values ≥70, and test-retest reliability revealed good to excellent values. Merely one dimension (Reduced activity) in UC patients reporting improvement did not reach the threshold for acceptable responsiveness according to Guyatt statistics. CONCLUSIONS The Norwegian version of MFI-20 is valid, reliable and responsive. The instrument can safely be used in studies using fatigue as an endpoint.
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Affiliation(s)
- Lars-Petter Jelsness-Jørgensen
- Faculty of Health, Welfare and Organisation, Østfold University College, Halden, Norway
- Department of Gastroenterology, Østfold Hospital Trust, Grålum, Norway
| | - Bjørn Moum
- Department of Gastroenterology, Oslo University Hospital, Nydalen, Norway
- Institute of Clinical Medicine, University of Oslo, Blindern, Norway
| | - Tore Grimstad
- Department of Gastroenterology, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jørgen Jahnsen
- Institute of Clinical Medicine, University of Oslo, Blindern, Norway
- Department of Gastroenterology, Akershus University Hospital, Lillestrøm, Norway
| | - Øistein Hovde
- Institute of Clinical Medicine, University of Oslo, Blindern, Norway
- Department of Gastroenterology, Innlandet Hospital Trust, Gjøvik, Norway
| | - Svein Oskar Frigstad
- Institute of Clinical Medicine, University of Oslo, Blindern, Norway
- Department of Medicine, VestreViken Baerum Hospital, Gjettum, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, Blindern, Norway
- Vestfold Hospital Trust, Tønsberg, Norway
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13
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Tsarpali V, Midtvedt K, Lønning K, Bernklev T, Lippe NVD, Reisæter AV, Brunborg C, Heldal K. Health-Related Quality of Life in Older Kidney Transplant Recipients: A National Cohort Study of Short- and Longer-Term Outcomes. Kidney Med 2021; 3:974-983.e1. [PMID: 34939006 PMCID: PMC8664696 DOI: 10.1016/j.xkme.2021.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Rationale & Objective Assessing the optimal therapy for older patients (aged ≥65 years) with end-stage kidney disease requires knowledge of longevity and health-related quality of life (HRQoL) outcomes. Kidney transplantation prolongs survival but its long-term impact on HRQoL in older recipients is not well defined. We aimed to prospectively evaluate HRQoL changes from enlisting until 3 years posttransplantation and examine pretransplantation predictors of posttransplantation outcomes. Study Design Prospective cohort study. Setting & Participants Patients 65 years and older enlisted at the Norwegian National Transplant Center between January 2013 and November 2016. Predictors Kidney transplantation, dialysis vintage, and pretransplantation comorbidity assessed using the Liu Comorbidity Index. Outcomes HRQoL, assessed using the Kidney Disease Quality of Life Short Form, version 1.3. Analytical Approach HRQoL scores obtained at 3 years posttransplantation were compared with those obtained pretransplantation and after 1 year using a paired-sample t test. Multivariable linear mixed-effect models were used to identify possible predictors of HRQoL changes over time. Results Among 289 patients included, 220 (mean age, 71.5 years) had undergone transplantation and 136 had completed the 3-year HRQoL follow-up by October 2020. Posttransplant HRQoL, both generic and kidney specific, substantially improved and the benefit persisted for 3 years. For wait-listed candidates remaining on dialysis, HRQoL gradually deteriorated, and recipients who died within 3 years posttransplantation experienced no improvement during the first year. Moderately elevated pretransplantation comorbidity scores and prolonged dialysis vintage independently predicted poor HRQoL outcomes posttransplantation. Recipients receiving dialysis for 1 year or longer with pretransplantation comorbidity scores ≥ 7 experienced a marked and sustained physical deterioration after transplantation. Limitations Homogenous and highly selected population. Conclusions Transplantation is associated with a sustained HRQoL improvement and should be the preferred treatment for selected older patients. The value of a pretransplant comorbidity score to predict posttransplantation outcomes warrants further evaluation and may improve the selection process.
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Affiliation(s)
- Vasiliki Tsarpali
- Clinic of Internal Medicine, Telemark Hospital Trust, Skien, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Karsten Midtvedt
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Kjersti Lønning
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Tomm Bernklev
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Research and Innovation, Vestfold Hospital Trust, Tønsberg, Oslo University Hospital, Oslo, Norway
| | - Nanna von der Lippe
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Anna Varberg Reisæter
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Cathrine Brunborg
- Oslo Center for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Kristian Heldal
- Clinic of Internal Medicine, Telemark Hospital Trust, Skien, Norway.,Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
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14
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Astrup GL, Rohde G, Rimehaug SA, Andersen MH, Bernklev T, Bjordal K, Falk RS, Jørgensen NMH, Stavem K, Tollisen A, Amdal CD. Comparing the use of patient-reported outcomes in clinical studies in Europe in 2008 and 2018: a literature review. Qual Life Res 2021; 31:659-669. [PMID: 34350566 PMCID: PMC8921066 DOI: 10.1007/s11136-021-02946-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Several guidelines for the use of patient-reported outcomes (PROs) in clinical studies have been published in the past decade. This review primarily aimed to compare the number and compliance with selected PRO-specific criteria for reporting of clinical studies in Europe using PROs published in 2008 and 2018. Secondarily, to describe the study designs, PRO instruments used, patient groups studied, and countries where the clinical studies were conducted. METHODS A literature search was conducted in MEDLINE to identify eligible publications. To assess the number of publications, all abstracts were screened for eligibility by pairs of reviewers. Compliance with PRO-specific criteria and other key characteristics was assessed in a random sample of 150 eligible full-text publications from each year. Randomized controlled trials (RCTs) were assessed according to the full CONSORT-PRO checklist. RESULTS The search identified 1692 publications in 2008 and 4290 in 2018. After screening of abstracts, 1240 from 2008 and 2869 from 2018 were clinical studies using PROs. By full-text review, the proportion of studies discussing PRO-specific limitations and implications was higher in 2018 than in 2008, but there were no differences in the other selected PRO-specific criteria. In 2018, a higher proportion of studies were longitudinal/cohort studies, included ≥ 300 patients, and used electronic administration of PRO than in 2008. The most common patient groups studied were those with cancer or diseases of the musculoskeletal system or connective tissue. CONCLUSION The number of clinical studies from Europe using PROs was higher in 2018 than in 2008, but there was little difference in compliance with the PRO-specific criteria. The studies varied in terms of study design and PRO instruments used in both publication years.
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Affiliation(s)
| | - Gudrun Rohde
- Department of Clinical Research, Sørlandet Hospital, Kristiansand, Norway.,Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | | | - Marit Helen Andersen
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tomm Bernklev
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Research and Innovation, Vestfold Hospital, Tønsberg, Norway
| | - Kristin Bjordal
- Research support services, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | | | - Knut Stavem
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Pulmonary Medicine, Akershus University Hospital, Lørenskog, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Anita Tollisen
- Unger-Vetlesens Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
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15
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Tsarpali V, Midtvedt K, Lønning K, Bernklev T, Von der Lippe N, Reisater AV, Heldal K. MO923PREDICTING POST-TRANSPLANT HRQOL TO OPTIMIZE OUTCOMES IN OLDER KIDNEY TRANSPLANT RECIPIENTS. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab110.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Kidney transplantation (KT) is the optimal treatment for older patients in need for kidney replacement therapy, with favorable outcomes both on survival, and health-related quality of life (HRQoL). Given the current organ scarcity, allocation of transplants should prioritize patients who are expected to benefit most from KT and identifying reliable predictors of post-transplant HRQoL outcomes is essential to optimize the selection process.
Method
Patients ≥ 65 years, who were enlisted for KT between January 2013 and November 2016 at the Norwegian national transplant center, were asked to participate. Self-reported HRQoL was assessed using the Kidney-Disease Quality of Life Short Form version 1.3 (KDQOL-SF) survey. Pre-transplant comorbidity was assessed by the Liu comorbidity index (LCI). Linear mixed-effect models were used to detect HRQoL changes over time (pre-KT, at -6, -12 and -36 months post-KT), and to identify pre-transplant predictors of post-transplant outcomes.
Results
By November 2020, 220 (76%) out of 289 enrolled participants, were transplanted. The mean age at KT was 71.8 (4.1) years, 154 (70%) were males, 57 (26%) were transplanted pre-emptively and 30 (13.6%) received a transplant from a living donor.
Longer dialysis vintage was independently associated with impaired physical function post-transplantion (Figure 1). Pre-transplant LCI score ≥ 7 consistently predicted poorer HRQoL outcomes at baseline and after 3-years, compared with LCI score < 7 (Figure 2). At 3- years post-transplant, increasing LCI score was lineary associated with decreasing SF-36 scores. Recipients on dialysis for ≥ 1 year with LCI ≥ 7 experienced the worst outcomes, with a marked and sustained post-transplant physical deterioration (Figure 3).
Conclusion
Older wait-listed candidates either on dialysis for >1 year or with elevated pre-transplant LCI are at high risk for impaired HRQoL post-transplant outcomes and should be re-evaluated with respect to transplantability on a regular basis. The identification of criteria to optimize the selection of older transplant candidates should be the scope of future studies
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Affiliation(s)
- Vasiliki Tsarpali
- Telemark Hospital Trust, Clinic of Internal Medicine, Skien, Norway
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Karsten Midtvedt
- Oslo University Hospital, Department of Transplantation Medicine, Section of Nephrology, Oslo, Norway
| | - Kjersti Lønning
- Oslo University Hospital, Department of Transplantation Medicine, Section of Nephrology, Oslo, Norway
| | - Tomm Bernklev
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway
- Vestfold Hospital Trust, Department of Research and Innovation, Tønsberg, Norway
| | - Nanna Von der Lippe
- Oslo University Hospital, Department of Medicine, Section of Nephrology, Oslo, Norway
| | - Anna Varberg Reisater
- Oslo University Hospital, Department of Transplantation Medicine, Section of Nephrology, Oslo, Norway
| | - Kristian Heldal
- Telemark Hospital Trust, Clinic of Internal Medicine, Skien, Norway
- Oslo University Hospital, Department of Transplantation Medicine, Section of Nephrology, Oslo, Norway
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16
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Normann CO, Opheim R, Andreassen BK, Bernklev T, Haug ES. Health-related quality-of-life after radical cystectomy among Norwegian men and women compared to the general population. Scand J Urol 2020; 54:181-187. [DOI: 10.1080/21681805.2020.1754906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | - Randi Opheim
- Faculty of Health and Society, University of Oslo, Oslo, Norway
| | | | - Tomm Bernklev
- Department of Research and Innovation, Vestfold Hospital Trust, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik S. Haug
- Department of Urology, Vestfold Hospital Trust, Oslo, Norway
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17
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Nilsson R, Dahl AA, Bernklev T, Kersten H, Haug ES. Work status and work ability after radical prostatectomy or active surveillance for prostate cancer. Scand J Urol 2020; 54:194-200. [PMID: 32285740 DOI: 10.1080/21681805.2020.1750473] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: Being able to work is important for health-related quality of life (HRQoL), and little is known about work life after radical treatment for prostate cancer (PCa). The aim was to investigate work status (WS) and work ability (WA) after radical prostatectomy (RP) or active surveillance (AS) for PCa, and to identify factors associated with reduced WA.Materials and methods: This is a retrospective cross-sectional study of 606 men treated with RP (n = 442) or AS (n = 164) at two Norwegian general hospitals. In 2017, they were asked to complete questionnaires measuring adverse effects (AE), HRQoL, aspects of work life and psychological factors at a median of 4.1 (range 1.3-8.1) years after diagnosis. Clinical data were retrieved from medical records. WS was categorized into employed, unemployed or retired. WA was rated using the Work Ability Index. Regression analyses were performed to find factors associated with reduced WA.Results: WS was similar for the RP and AS groups at diagnosis and survey. There was a small reduction in WA from diagnosis to survey and the difference between the RP and AS groups was non-significant. Older age, poorer self-rated health, poorer incontinence score, more chronic fatigue, and increased anxiety and depressive symptoms were associated with reduced WA, while treatment method, urinary bother and use of pads were not.Conclusion: The impact of RP and AS on WS and WA was almost similar. Age and psychological variables were more strongly associated with reduced WA than cancer-related variables.
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Affiliation(s)
- Rasmus Nilsson
- Department of Urology, Telemark Hospital Trust, Skien, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Alv A Dahl
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,National Advisory Unit for Late Effects after Cancer Therapy, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Research and Development, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Research and Development, Telemark Hospital Trust, Skien, Norway
| | - Hege Kersten
- Department of Research and Development, Telemark Hospital Trust, Skien, Norway.,Department of Pharmaceutical Bioscience, School of Pharmacy, University of Oslo, Norway
| | - Erik S Haug
- Department of Urology, Vestfold Hospital Trust, Tønsberg, Norway.,Institute of Cancer Genomics and Informatics, Oslo University Hospital, Oslo, Norway
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18
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Klepp P, Brackmann S, Cvancarova M, Hoivik ML, Hovde Ø, Henriksen M, Huppertz-Hauss G, Bernklev T, Hoie O, Kempski-Monstad I, Solberg IC, Stray N, Jahnsen J, Vatn MH, Moum B. Risk of colorectal cancer in a population-based study 20 years after diagnosis of ulcerative colitis: results from the IBSEN study. BMJ Open Gastroenterol 2020; 7:e000361. [PMID: 32337058 PMCID: PMC7170403 DOI: 10.1136/bmjgast-2019-000361] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/17/2020] [Accepted: 02/21/2020] [Indexed: 02/06/2023] Open
Abstract
Objective The association between ulcerative colitis (UC) and colorectal cancer (CRC) is widely accepted, although attenuated risk has been reported in recent years. Colonoscopic surveillance is recommended with intervals based on established clinical risk factors. Nevertheless, a significant number of patients develop interval cancers, indicating the need of improved individualised assessment. In the present study, we evaluated clinical risk factors associated with CRC during a prescheduled follow-up 20 years after diagnosis, the IBSEN study. Design A population-based inception cohort of patients diagnosed with inflammatory bowel disease from 1 January 1990 until 31 December 1993, prospectively followed at 1, 5, 10 and 20 years after diagnosis. A total of 517 patients with UC were included; 264 (51 %) men; median age at inclusion 37.4 years (4–88). Results The overall incidence of CRC was 1.6% (8/517) at a 20-year follow-up. The total lifetime risk of CRC prior to or after UC diagnosis was 2.3%. (12/517). Patients older than 70 years at diagnosis had a 15-fold higher risk of CRC compared with those diagnosed when younger than 40 years, with HR 15.68 (95% CI: 1.31 to 187.92). Neither sex, first-degree relative with CRC, extent of colitis nor primary sclerosing cholangitis affected the risk of CRC. Conclusion The risk of CRC in UC was low and comparable with the risk of CRC in the background population of Norway.
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Affiliation(s)
- Pasquale Klepp
- Unger-Vetlesen Institute, Lovisenberg Diakonale Hospital, Oslo, Norway.,Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Stephan Brackmann
- Department of Gastroenterology, Akershus University Hospital, Lorenskog, Norway.,Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Milada Cvancarova
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marte Lie Hoivik
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Øistein Hovde
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Gastroenterology, Innlandet Hospital Trust, Gjøvik, Oppland, Norway
| | - Magne Henriksen
- Department of Gastroenterology, Østfold Hospital Trust, Gralum, Kalnes, Norway
| | - Gert Huppertz-Hauss
- Department of Gastroenterology, Telemark Hospital, Ulefossveien, Skien, Norway
| | - Tomm Bernklev
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.,R&D Department, Vestfold Hospital Trust, Tonsberg, Norway
| | - Ole Hoie
- Department of Internal Medicine, Sørlandet Hospital, Sykehusveien, Arendal, Norway
| | | | | | - Njaal Stray
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | - Jorgen Jahnsen
- Department of Gastroenterology, Akershus University Hospital, Lorenskog, Norway.,Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Morten H Vatn
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bjorn Moum
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
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19
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Opheim R, Moum B, Grimstad BT, Jahnsen J, Prytz Berset I, Hovde Ø, Huppertz-Hauss G, Bernklev T, Jelsness-Jørgensen LP. Self-esteem in patients with inflammatory bowel disease. Qual Life Res 2020; 29:1839-1846. [PMID: 32144613 PMCID: PMC7295843 DOI: 10.1007/s11136-020-02467-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2020] [Indexed: 01/19/2023]
Abstract
Purpose The purpose of this study was to explore self-esteem and associations between self-esteem and sociodemographic, clinical, and psychological factors in patients with inflammatory bowel disease (IBD), a disease of chronic relapsing inflammation of the gastrointestinal tract. IBD symptoms, including pain, fatigue, and diarrhea, as well as potential life-long medical treatment and surgery, may be demanding, cause significant challenges, and influence self-esteem. Methods In this cross-sectional multicenter study, participants were recruited from nine hospitals in the southeastern and western regions of Norway from March 2013 to April 2014. Data were collected using self-report questionnaires. Self-esteem was assessed by the Rosenberg Self-Esteem Scale, fatigue was assessed by the Fatigue Questionnaire, self-efficacy was assessed by the General Self-Efficacy Scale, and disease activity was assessed by the Simple Clinical Colitis Activity Index for ulcerative colitis (UC) and Harvey Bradshaw Index for Crohn’s disease (CD). Multiple linear regression analysis was applied to examine associations between self-esteem and sociodemographic, clinical, and psychological factors. Results In total, 411 of 452 (91%) patients had evaluable data and were included in this study. The mean scores on self-esteem, self-efficacy, total fatigue, anxiety, and depression were similar between UC patients and CD patients. Male gender, being employed, and higher self-efficacy were independently associated with higher self-esteem, whereas anxiety and depression were independently associated with lower self-esteem. Neither disease activity nor fatigue were associated with self-esteem in the final multiple regression analyses. Conclusion Patient-centered interventions that improve self-esteem and reduce anxiety and depression seem to be important to optimize IBD management.
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Affiliation(s)
- Randi Opheim
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway. .,Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Bjørn Moum
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Bjørn Tore Grimstad
- Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jørgen Jahnsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway
| | - Ingrid Prytz Berset
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Medicine, Aalesund Hospital Trust, Aalesund, Norway
| | - Øistein Hovde
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Internal Medicine, Innlandet Hospital Trust, Gjøvik, Norway
| | | | - Tomm Bernklev
- Department of Research and Development, Vestfold Hospital Trust, Tønsberg, Norway
| | - Lars-Petter Jelsness-Jørgensen
- Department of Gastroenterology, Østfold Hospital Trust, Grålum, Norway.,Department of Health Sciences, Østfold University College, Fredrikstad, Norway
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20
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Ossum AM, Palm Ø, Cvancarova M, Bernklev T, Jahnsen J, Moum B, Høivik ML. The Impact of Spondyloarthritis and Joint Symptoms on Health-Related Quality of Life and Fatigue in IBD Patients. Results From a Population-Based Inception Cohort (20-Year Follow-up in the Ibsen Study). Inflamm Bowel Dis 2020; 26:114-124. [PMID: 31127829 DOI: 10.1093/ibd/izz105] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Patients with inflammatory bowel disease (IBD) often suffer from musculoskeletal manifestations. Health-related quality of life (HRQoL) and fatigue are known to be associated with IBD activity and musculoskeletal complaints. The aim of this study was to determine the association between spondyloarthritis, arthralgia, or back pain and the patient-reported outcomes of HRQoL and fatigue in IBD patients 20 years after their diagnosis. METHODS The IBSEN cohort was followed prospectively for 20 years. At the 20-year follow-up, the patients answered detailed questionnaires regarding rheumatological manifestations, intestinal symptoms, HRQoL, and fatigue. Multiple regression analyses were used to evaluate associations between spondyloarthritis or joint symptoms and HRQoL or fatigue. Sex, IBD diagnosis, and age were included in all the multiple regression models, in addition to other clinically relevant confounders. RESULTS In total, 441 patients (94%) completed the questionnaires at the 20-year follow-up. The criteria for spondyloarthritis (axial or peripheral) were fulfilled in 158 patients (36%), current back pain during the previous 3 months was reported by 79 patients (18%), and current arthralgia was reported by 178 patients (40%). Current back pain and arthralgia were independently associated with lower HRQoL, higher levels of fatigue, and chronic fatigue. A diagnosis of spondyloarthritis was not associated with reduced HRQoL or fatigue when adjusted for possible confounders. CONCLUSIONS Current joint symptoms in IBD patients 20 years after diagnosis were associated with poorer HRQoL, higher levels of fatigue, and chronic fatigue, whereas spondyloarthritis did not impact HRQoL or fatigue negatively in this cohort.
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Affiliation(s)
- Alvilde Maria Ossum
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Palm
- Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,R&D Department, Vestfold Hospital Trust, Tønsberg, Norway
| | - Jørgen Jahnsen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway
| | - Bjørn Moum
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marte Lie Høivik
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
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21
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Frigstad SO, Høivik ML, Jahnsen J, Cvancarova M, Grimstad T, Berset IP, Huppertz-Hauss G, Hovde Ø, Bernklev T, Moum B, Jelsness-Jørgensen LP. Pain Severity and Vitamin D Deficiency in IBD Patients. Nutrients 2019; 12:nu12010026. [PMID: 31877637 PMCID: PMC7019855 DOI: 10.3390/nu12010026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/10/2019] [Accepted: 12/18/2019] [Indexed: 12/22/2022] Open
Abstract
Background: Pain and vitamin D deficiency are common in inflammatory bowel disease (IBD). Disease activity, fatigue, frequent relapses, prior surgery and psychological factors all seem to influence the experience of pain in IBD. Vitamin D deficiency has been associated with muscle and skeletal pain. This study aimed to determine whether there is an association between vitamin D deficiency and severity of pain in patients with IBD, and to investigate the influence of other socio-demographic and psychological variables on the experience of pain. Methods: Patients with IBD were recruited from nine hospitals in Norway in a multicenter cross-sectional study. The Brief Pain Inventory (BPI) questionnaire was used to measure pain. Disease activity was assessed using clinical disease activity indices, C-reactive protein (CRP) and fecal calprotectin. Regression models were fitted to explore a possible association between 25-hydroxyvitamin D and pain severity. Results: Of 407 patients included in the analyses, 229 (56%) had Crohn’s disease (CD) and 178 (44%) had ulcerative colitis (UC). Vitamin D deficiency was present in half (203/407) of patients. Presence of pain was reported by 76% (309/407). More severe pain was associated with female gender and increased disease activity scores, but not with increased CRP or fecal calprotectin. In CD, patients without prior intra-abdominal surgery reported more severe pain. In multivariate analyses, there was no association between 25-hydroxyvitamin D and pain severity. Conclusions: In this study, no significant association between pain severity and vitamin D deficiency was revealed in patients with IBD.
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Affiliation(s)
- Svein Oskar Frigstad
- Department of Research, Østfold Hospital, 1714 Grålum, Norway
- Department of Medicine, Vestre Viken Bærum Hospital, 1346 Gjettum, Norway
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Correspondence: ; Tel.: +47-6780-9587
| | - Marte Lie Høivik
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Department of Gastroenterology, Oslo University Hospital, 0424 Oslo, Norway;
| | - Jørgen Jahnsen
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Department of Gastroenterology, Akershus University Hospital, 1478 Nordbyhagen, Norway
| | - Milada Cvancarova
- Department of Gastroenterology, Oslo University Hospital, 0424 Oslo, Norway;
- Department of Biostatistics, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Tore Grimstad
- Department of Gastroenterology, Stavanger University Hospital, 4068 Stavanger, Norway;
| | - Ingrid Prytz Berset
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
| | | | - Øistein Hovde
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Department of Medicine, Innlandet Hospital, 2819 Gjøvik, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Department of Research and Development, Vestfold Hospital, 3103 Tønsberg, Norway
| | - Bjørn Moum
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Department of Gastroenterology, Oslo University Hospital, 0424 Oslo, Norway;
| | - Lars-Petter Jelsness-Jørgensen
- Department of Gastroenterology, Østfold Hospital, 1714 Grålum, Norway;
- Department of Health Sciences, Østfold University College, 1757 Halden, Norway
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22
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Guldvog I, Reitsma LC, Johnsen L, Lauzike A, Gibbs C, Carlsen E, Lende TH, Narvestad JK, Omdal R, Kvaløy JT, Hoff G, Bernklev T, Søiland H. Thyroidectomy Versus Medical Management for Euthyroid Patients With Hashimoto Disease and Persisting Symptoms: A Randomized Trial. Ann Intern Med 2019; 170:453-464. [PMID: 30856652 DOI: 10.7326/m18-0284] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Hashimoto disease is a chronic autoimmune thyroiditis. Despite adequate hormone substitution, some patients have persistent symptoms that may be the result of immunologic pathophysiology. OBJECTIVE To determine whether thyroidectomy improves symptoms in patients with Hashimoto thyroiditis who still have symptoms despite having normal thyroid gland function while receiving medical therapy. DESIGN Randomized trial. (ClinicalTrials.gov: NCT02319538). SETTING Secondary care hospital in Norway. PATIENTS 150 patients aged 18 to 79 years with persistent Hashimoto-related symptoms despite euthyroid status while receiving hormone replacement therapy and with serum antithyroid peroxidase (anti-TPO) antibody titers greater than 1000 IU/mL. INTERVENTION Total thyroidectomy or medical management with hormone substitution to secure euthyroid status in both groups. MEASUREMENTS The primary outcome was general health score on the Short Form-36 Health Survey (SF-36) at 18 months. Secondary outcomes were adverse effects of surgery, the other 7 SF-36 subscores, fatigue questionnaire scores, and serum anti-TPO antibody titers at 6, 12, and 18 months. RESULTS During follow-up, only the surgical group demonstrated improvement: Mean general health score increased from 38 to 64 points, for a between-group difference of 29 points (95% CI, 22 to 35 points) at 18 months. Fatigue score decreased from 23 to 14 points, for a between-group difference of 9.3 points (CI, 7.4 to 11.2 points). Chronic fatigue frequency decreased from 82% to 35%, for a between-group difference of 39 percentage points (CI, 23 to 53 percentage points). Median serum anti-TPO antibody titers decreased from 2232 to 152 IU/mL, for a between-group difference of 1148 IU/mL (CI, 1080 to 1304 IU/mL). In multivariable regression analyses, the adjusted treatment effects remained similar to the unadjusted effects. LIMITATION Results are applicable only to a subgroup of patients with Hashimoto disease, and follow-up was limited to 18 months. CONCLUSION Total thyroidectomy improved health-related quality of life and fatigue, whereas medical therapy did not. This improvement, along with concomitant elimination of serum anti-TPO antibodies, may elucidate disease mechanisms. PRIMARY FUNDING SOURCE Telemark Hospital.
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Affiliation(s)
- Ivar Guldvog
- Telemark Hospital, Skien, Norway (I.G., L.C.R., A.L., C.G., E.C., G.H.)
| | | | - Lene Johnsen
- Stavanger University Hospital, Stavanger, Norway (L.J., J.K.N.)
| | - Andromeda Lauzike
- Telemark Hospital, Skien, Norway (I.G., L.C.R., A.L., C.G., E.C., G.H.)
| | - Charlotte Gibbs
- Telemark Hospital, Skien, Norway (I.G., L.C.R., A.L., C.G., E.C., G.H.)
| | - Eivind Carlsen
- Telemark Hospital, Skien, Norway (I.G., L.C.R., A.L., C.G., E.C., G.H.)
| | - Tone Hoel Lende
- Stavanger University Hospital, Stavanger, Norway, and University of Bergen, Bergen, Norway (T.H.L., R.O., H.S.)
| | | | - Roald Omdal
- Stavanger University Hospital, Stavanger, Norway, and University of Bergen, Bergen, Norway (T.H.L., R.O., H.S.)
| | - Jan Terje Kvaløy
- University of Stavanger and Stavanger University Hospital, Stavanger, Norway (J.T.K.)
| | - Geir Hoff
- Telemark Hospital, Skien, Norway (I.G., L.C.R., A.L., C.G., E.C., G.H.)
| | - Tomm Bernklev
- Telemark Hospital, Skien, Norway, Vestfold Hospital, Tønsberg, Norway, and University of Oslo, Oslo, Norway (T.B.)
| | - Håvard Søiland
- Stavanger University Hospital, Stavanger, Norway, and University of Bergen, Bergen, Norway (T.H.L., R.O., H.S.)
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23
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Lønning K, Midtvedt K, Bernklev T, Brunborg C, Andersen MH, von der Lippe N, Reisaeter AV, Line PD, Hartmann A, Heldal K. Changes in health-related quality of life in older candidates waiting for kidney transplantation. Nephrology (Carlton) 2019; 23:948-956. [PMID: 28734131 DOI: 10.1111/nep.13117] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 07/15/2017] [Indexed: 11/28/2022]
Abstract
AIM There is limited available knowledge regarding health-related quality of life (HRQoL) in older patients with chronic kidney disease. We aimed to describe HRQoL in renal transplant candidates 65 years or older at transplant acceptance, and during the first year on the waiting list. METHODS A nationwide prospective observational study in Norway was conducted. HRQoL was evaluated at baseline (wait listing) and after 6 and 12 months using the patient self-reported Kidney Disease and Quality of Life Short form version 1.3. Intra-individual scores at different times were evaluated. Generic HRQoL was compared with scores from an age-matched Norwegian population. RESULTS From January 2013 to November 2016, 261 patients ≥65 years accepted for deceased donor kidney transplantation were included. Mean age at inclusion was 71.1 years, 67% male and 69% were on dialysis. HRQoL sum scores significantly decreased during the first year on the waiting list. Physical, mental and kidney disease component summary score reduced from 39.6 to 38.1 (P = 0.045), 48.8 to 44.7 (P < 0.001) and 72.1 to 70.2 (P = 0.03), respectively. When evaluating each domain separately, only the decrease in social function was clinically significant. Age and being on dialysis were the most important predictors for low HRQoL. Compared to the age-matched general population, males had significant lower HRQoL scores. Females were comparable to the general female population at baseline except in general health and vitality. CONCLUSIONS HRQoL in older patients waiting for kidney transplantation decreases during the first year on the waiting list, but only the change in social function is clinically significant.
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Affiliation(s)
- Kjersti Lønning
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Karsten Midtvedt
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Norway
| | - Tomm Bernklev
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Research and Development, Vestfold Hospital Trust, Tønsberg, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Marit H Andersen
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Norway.,Faculty of Medicine, Department of Health Sciences, University of Oslo, Oslo, Norway
| | - Nanna von der Lippe
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anna V Reisaeter
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Norway
| | - Pål-Dag Line
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anders Hartmann
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristian Heldal
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Nephrology, Endocrinology and Emergency Medicine, Clinic of Internal Medicine, Telemark Hospital Trust, Skien, Norway
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24
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Heldal K, Midtvedt K, Lønning K, Iversen T, Hernæs KH, Tsarpali V, Reisæter AV, Bernklev T. Kidney transplantation: an attractive and cost-effective alternative for older patients? A cost-utility study. Clin Kidney J 2019; 12:888-894. [PMID: 31807304 PMCID: PMC6885668 DOI: 10.1093/ckj/sfz018] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Indexed: 12/29/2022] Open
Abstract
Background In the elderly, kidney transplantation is associated with increased survival and improved health-related quality of life compared with dialysis treatment. We aimed to study the short-term health economic effects of transplantation in a population of elderly kidney transplant candidates. Methods Self-perceived health, quality-adjusted life years (QALYs) and costs were evaluated and compared 1 year before and 1 year after kidney transplantation in patients included in a single-centre prospective study of 289 transplant candidates ≥65 years of age. Results Self-perceived health and QALYs both significantly improved after transplantation. At 1 year, the costs per QALY were substantially higher for transplantation (€88 100 versus €76 495), but preliminary analyses suggest a favourable long-term health economic effect. Conclusions Kidney transplantation in older kidney transplant recipients is associated with improved health but also with increased costs the first year after engraftment when compared with remaining on the waiting list. Any long-term cost-effectiveness needs to be confirmed in studies with longer observation times.
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Affiliation(s)
- Kristian Heldal
- Clinic of Internal Medicine, Telemark Hospital Trust, Skien, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Karsten Midtvedt
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Kjersti Lønning
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Tor Iversen
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | | | - Vasiliki Tsarpali
- Clinic of Internal Medicine, Telemark Hospital Trust, Skien, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anna Varberg Reisæter
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Tomm Bernklev
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Research and Innovation, Vestfold Hospital Trust, Tonsberg, Norway
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25
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Jelsness-Jørgensen LP, Jensen Ø, Gibbs C, Bekkhus Moe R, Hofsø D, Bernklev T. Psychometric testing of the Norwegian Diabetes Health Profile (DHP-18) in patients with type 1 diabetes. BMJ Open Diabetes Res Care 2018; 6:e000541. [PMID: 30613400 PMCID: PMC6304096 DOI: 10.1136/bmjdrc-2018-000541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 09/14/2018] [Accepted: 11/08/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The Diabetes Health Profile-18 (DHP-18) was developed to measure disease-specific health-related quality of life. It has been translated into Norwegian but remains invalidated. The purpose of this paper was to examine the psychometric properties of the Norwegian DHP-18. RESEARCH DESIGN AND METHODS Participants with type 1 diabetes were recruited from three outpatient clinics in Norway. Clinical and sociodemographic data were collected, and participants completed the DHP-18 and the Short-Form 36 (SF-36). Descriptive analysis, frequencies, t-tests and the chi-squared tests were used. Principal axis factoring (PAF) and confirmatory factor analysis (CFA) were used. Convergent validity was tested using Spearman's correlation between the DHP-18 and SF-36. Reliability was tested using Cronbach's alpha and intraclass correlation coefficient. RESULTS In total, 288 patients were included. No floor and ceiling effects were found. A forced PAF analysis revealed that three questions had an eigenvalue below 0.40. In the unforced PAF analysis, one question loaded below 0.40, while three questions loaded into a fourth factor. The correlation between the DHP-18 and SF-36 dimensions was low to moderate. Problematic internal consistency was observed for the disinhibited eating dimension in the forced PAF and in the suggested fourth dimension in the unforced PAF. CFA revealed poor fit. The test-retest reliability displayed good to excellent values, but responsiveness was limited. CONCLUSIONS Problematic issues were identified regarding factor structure, item loadings, internal consistency and responsiveness. Further evaluation of responsiveness is particularly recommended, and using a revised 14-item DHP version is suggested.
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Affiliation(s)
- Lars-Petter Jelsness-Jørgensen
- Department of Health and Welfare, Østfold University College, Halden, Norway
- Department of Internal Medicine, Østfold Hospital Trust, Grålum, Norway
| | - Øystein Jensen
- Department of Health and Welfare, Østfold University College, Halden, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Charlotte Gibbs
- Department of Endocrinology, Telemark Hospital Trust, Skien, Norway
| | | | - Dag Hofsø
- Morbid Obesity Centre and Section of Endocrinology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research and Development, Vestfold Hospital Trust, Tønsberg, Norway
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26
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Jelsness-Jørgensen LP, Bernklev T, Lundin KEA. Fatigue as an Extra-Intestinal Manifestation of Celiac Disease: A Systematic Review. Nutrients 2018; 10:nu10111652. [PMID: 30400298 PMCID: PMC6266448 DOI: 10.3390/nu10111652] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 12/30/2022] Open
Abstract
Celiac disease may present with a range of different symptoms, including abdominal problems in a broader sense, iron deficiency and “constant tiredness”. All of these symptoms should consequently lead the clinicians to consider celiac disease as a potential etiopathogenetic cause. Although the pathophysiology of celiac disease is well documented, the actual mechanisms for disease presentation(s) are less well understood. We here address the topic of fatigue in celiac disease. A systematic literature search identified 298 papers of which five met the criteria for full evaluation. None of the reviewed papers were of high quality and had several methodological weaknesses. We conclude that there is an unmet need to study the contributing factors and management of fatigue in celiac disease.
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Affiliation(s)
- Lars-Petter Jelsness-Jørgensen
- Department of Health Science, Østfold University College, N-1757 Halden, Norway.
- Department of Gastroenterology, Østfold Hospital Trust Kalnes, N-1714 Grålum, Norway.
| | - Tomm Bernklev
- Department of Research and Innovation, Vestfold Hospital Trust, N-3103 Tønsberg, Norway.
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, N-0318 Oslo, Norway.
| | - Knut E A Lundin
- K.G. Jebsen Coeliac Disease Research Centre, University of Oslo, N-0318 Oslo, Norway.
- Department of gastroenterology, Oslo University Hospital Rikshospitalet, N-0372 Oslo, Norway.
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27
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Jensen Ø, Bernklev T, Gibbs C, Moe RB, Hofsø D, Jelsness-Jørgensen LP. Fatigue in type 1 diabetes, prevalence, predictors and comparison with the background population. Diabetes Res Clin Pract 2018; 143:71-78. [PMID: 29969723 DOI: 10.1016/j.diabres.2018.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/29/2018] [Accepted: 06/13/2018] [Indexed: 11/15/2022]
Abstract
AIM Fatigue is scarcely studied in type 1 diabetes (T1D), and the aims were to investigate its prevalence compared to the background population, potential associations, and to validate the Fatigue Questionnaire (FQ) in type 1 diabetes. METHODS Persons with T1D were recruited from three outpatient clinics in Norway. Fatigue was measured using the FQ, and FQ data from the Norwegian background population were used for comparison. Socio-demographic and clinical variables were obtained by self-report, clinical investigation, medical records and laboratory tests. RESULTS Of 332 eligible patients, 288 (87%) were included. Mean age was 44.65/44.95 years (SD 13.34/13.38) for females/males, respectively. Total fatigue (TF) was 15.31 (SD 5.51) compared to 12.2 (SD 4.0) in the background population (p < 0.001). HADS ≥ 8, current menstruation, increased leukocytes and sleep problems were associated with increased TF. Chronic fatigue (CF) was reported in 26.4% compared to 11% in the background population (p < 0.001). HADS ≥ 8, increased time since diagnosis and decreased sleep quality were associated with CF. The validity, internal consistency and repeatability of the FQ was confirmed. CONCLUSIONS Fatigue was more common in T1D than in the background population, and associated with increased anxiety, depression and sleep problems. The FQ demonstrated satisfactory psychometric properties.
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Affiliation(s)
- Øystein Jensen
- Østfold University College, Dept of Health and Welfare, Pb 770, 1757 Halden, Norway; Institute of Clinical Medicine, University of Oslo, Klaus Torgårds vei 3, 0372 Oslo, Norway.
| | - Tomm Bernklev
- Vestfold Hospital Trust, Research and Development, Halfdan Wilhelmsens alle 17, 3116 Tønsberg, Norway; Institute of Clinical Medicine, University of Oslo, Klaus Torgårds vei 3, 0372 Oslo, Norway.
| | - Charlotte Gibbs
- Telemark Hospital Trust, Dept of Endocrinology, Ulefossvegen 55, 3710 Skien, Norway.
| | - Ragnar Bekkhus Moe
- Østfold Hospital Trust, Dept of Internal Medicine, Kalnesveien 300, 1714 Grålum, Norway.
| | - Dag Hofsø
- Vestfold Hospital Trust, Morbid Obesity Centre and Section of Endocrinology, Halfdan Wilhelmsens alle 17, 3116 Tønsberg, Norway.
| | - Lars-Petter Jelsness-Jørgensen
- Østfold University College, Dept of Health and Welfare, Pb 770, 1757 Halden, Norway; Østfold Hospital Trust, Dept of Internal Medicine, Kalnesveien 300, 1714 Grålum, Norway.
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28
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Frigstad SO, Høivik ML, Jahnsen J, Cvancarova M, Grimstad T, Berset IP, Huppertz-Hauss G, Hovde Ø, Bernklev T, Moum B, Jelsness-Jørgensen LP. Fatigue is not associated with vitamin D deficiency in inflammatory bowel disease patients. World J Gastroenterol 2018; 24:3293-3301. [PMID: 30090009 PMCID: PMC6079290 DOI: 10.3748/wjg.v24.i29.3293] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/17/2018] [Accepted: 06/27/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate if vitamin D deficiency is associated with fatigue in patients with inflammatory bowel disease (IBD).
METHODS IBD patients were recruited from nine hospitals in the southeastern and western regions of Norway to participate in a multicenter cross-sectional study lasting from March 2013 to April 2014. Data were collected by interviews, from medical records and laboratory tests. The Fatigue Questionnaire (FQ) was used to measure fatigue. Linear and logistic regression models were applied to explore the possible association between vitamin D deficiency and total fatigue scores and chronic fatigue, respectively. The analyses were adjusted for age, gender, disease activity, depressive symptoms and sleep disturbance.
RESULTS In total, 405 patients were included in the analyses, of which 227 (56%) had Crohn’s disease (CD) and 178 (44%) had ulcerative colitis (UC). Vitamin D deficiency (< 50 nmol/L) was present in half (203/405) of the patients. Chronic fatigue was reported by 116 (29%) of all included patients with substantial fatigue reported by 194 (48%). Vitamin D levels were neither associated with total fatigue nor with chronic fatigue. Higher total fatigue scores and chronic fatigue were both associated with increased disease activity scores in patients with UC and CD, but not with increased CRP or fecal calprotectin. In UC patients, female gender was associated with fatigue in the univariate analysis, but no such difference was found when adjusted for elevated disease activity scores. Sleep disturbance and more depressive symptoms were associated with total fatigue scores in both UC and CD patients, but with chronic fatigue only in CD patients.
CONCLUSION In this study, no significant association between fatigue and vitamin D deficiency in IBD patients was revealed.
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Affiliation(s)
- Svein Oskar Frigstad
- Department of Medicine, Vestre Viken Bærum Hospital, Gjettum 1346, Norway
- Department of Research, Østfold Hospital Kalnes, Grålum 1714, Norway
| | - Marte Lie Høivik
- Department of Gastroenterology, Oslo University Hospital, Oslo 0424, Norway
| | - Jørgen Jahnsen
- Department of Gastroenterology, Akershus University Hospital, Lørenskog 1478, Norway
| | - Milada Cvancarova
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo 0130, Norway
| | - Tore Grimstad
- Department of Gastroenterology, Stavanger University Hospital, Stavanger 4068, Norway
| | | | | | - Øistein Hovde
- Department of Medicine, Innlandet Hospital Trust, Gjøvik 2819, Norway
| | - Tomm Bernklev
- Department of Research and Development, Vestfold Hospital Trust, Tønsberg 3103, Norway
| | - Bjørn Moum
- Department of Gastroenterology, Oslo University Hospital, Oslo 0424, Norway
| | - Lars-Petter Jelsness-Jørgensen
- Department of Gastroenterology, Østfold Hospital Kalnes, Grålum 1714, Norway
- Department of Health Sciences, Østfold University College, Halden 1757, Norway
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Lønning K, Tsarpali V, Midtvedt K, Bernklev T, Andersen M, Lippe N, Reisæter A, Line PD, Hartmann A, Heldal K. FP735OLD, KIDNEY TRANSPLANTED AND LIVING THE GOOD LIFE. IMPROVED HEALTH RELATED QUALITY OF LIFE THREE YEARS AFTER TRANSPLANTATION. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kjersti Lønning
- Faculty of Medicine, Institute of Clinical Medicine, University in Oslo, Oslo, Norway
- Rikshospitalet, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Karsten Midtvedt
- Rikshospitalet, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Tomm Bernklev
- Department of Research and Development, Vestfold Hospital Trust, Tønsbert, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University in Oslo, Oslo, Norway
| | - Marit Andersen
- Faculty of Medicine, Department of Health Sciences, University in Oslo, Oslo, Norway
- Rikshospitalet, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Nanna Lippe
- Faculty of Medicine, Institute of Clinical Medicine, University in Oslo, Oslo, Norway
| | - Anna Reisæter
- Rikshospitalet, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Pål-Dag Line
- Rikshospitalet, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University in Oslo, Oslo, Norway
| | - Anders Hartmann
- Rikshospitalet, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University in Oslo, Oslo, Norway
| | - Kristian Heldal
- Clinic of Internal Medicine, Telemark Hospital Trust, Skien, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University in Oslo, Oslo, Norway
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30
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Lunder AK, Jahnsen J, Bakstad LT, Borthne A, Hov JR, Vatn M, Negård A, Solberg IC, Bernklev T, Høie O, Henriksen M, Høivik ML, Hovde Ø, Huppertz-Hauss G, Monstad I. Bowel Damage in Patients With Long-term Crohn's Disease, Assessed by Magnetic Resonance Enterography and the Lémann Index. Clin Gastroenterol Hepatol 2018; 16:75-82.e5. [PMID: 28694130 DOI: 10.1016/j.cgh.2017.06.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 06/23/2017] [Accepted: 06/25/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Magnetic resonance enterography (MRE) is used to evaluate the extent and complications of Crohn's disease (CD). MRE results are used in calculation of the Lémann index (LI) score, which quantifies bowel damage. The long-term outcomes of CD are uncertain; we aimed to assess bowel disease and damage in patients with CD for 20 years using MRE and the LI. METHODS We performed a follow-up analysis of a population-based cohort of 237 patients in southeastern Norway diagnosed with CD from 1990 to 1993. Twenty years after diagnosis, 156 attended the evaluation in which they were offered routine clinical blood tests and colonoscopies. Ninety-six patients were examined by MRE and LI scores were calculated. The independent association of the LI score with clinical variables was examined by univariate analysis. RESULTS Sixty-five patients (67.7%) had CD manifestations based on findings from MRE (36.9%), colonoscopy (29.2%), or both (33.9%). MRE findings changed disease classification for 8 patients (8.3%). The median LI score was 4.6 (interquartile range, 17.5) and associated with younger age (P = .02), complicated ileocolonic phenotype (P < .001), and use of biologic (P < .001), or immunosuppressant therapies (P = .045). Factors independently associated with LI score during the follow-up period were age, complicated disease, use of medication, and markers of inflammation. CONCLUSIONS In a population-based study of 237 patients with CD in Norway, we found that almost 68% had imaging features of CD, half of which were only detectable by MRE. LI score associated with ongoing active disease. Young age, complicated disease, and persistent inflammation were associated with bowel damage.
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Affiliation(s)
- Aida Kapic Lunder
- Department of Radiology, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Jørgen Jahnsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway
| | | | - Arne Borthne
- Department of Radiology, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Johannes Roksund Hov
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Norwegian PSC Research Center and Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Morten Vatn
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; EpiGen Institute, Akershus University Hospital, Lørenskog, Norway
| | - Anne Negård
- Department of Radiology, Akershus University Hospital, Lørenskog, Norway
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31
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Enden T, Bernklev T, Jelsness-Jørgensen LP, Amdal CD. Pasientene kjenner best egen helse. Tidsskriftet 2018; 138:17-1054. [DOI: 10.4045/tidsskr.17.1054] [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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Kirkøen B, Berstad P, Botteri E, Dalén E, Nilsen JA, Hoff G, de Lange T, Bernklev T. Acceptability of two colorectal cancer screening tests: pain as a key determinant in sigmoidoscopy. Endoscopy 2017; 49:1075-1086. [PMID: 28938500 DOI: 10.1055/s-0043-117400] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Background Participants' experience with a screening test can influence adherence, and therefore the efficacy of screening programs. We compared screening with unsedated flexible sigmoidoscopy and fecal immunochemical testing (FIT) for participants' satisfaction with the decision and for willingness to repeat colorectal cancer screening. Methods In a prospective, randomized trial 3257 individuals (50 - 74 years) were invited to either flexible sigmoidoscopy or FIT (1:1), of whom 1650 took up the offer (52.6 %). In total, 1497 screening participants completed at least one questionnaire, either before screening, and/or at three time points in the following year, that measured willingness to repeat screening, willingness to recommend screening, and satisfaction with decision to attend. There were 769 and 728 responders in the flexible sigmoidoscopy and FIT group, respectively. Additionally, 581 flexible sigmoidoscopy participants also completed a pain questionnaire. Results 1 year later, 10 % of the flexible sigmoidoscopy participants were not willing to repeat screening, compared to 5 % of FIT participants. A higher percentage of women compared to men would not repeat flexible sigmoidoscopy screening (adjusted odds ratio [OR] 2.52, 95 % confidence interval [95 %CI] 1.48 to 4.28). Notably, 22 % of women reported pain during flexible sigmoidoscopy compared to 5 % of men. When we added pain to the statistical model, pain was significantly associated with unwillingness to repeat flexible sigmoidoscopy (OR 3.15, 95 %CI 1.68 to 5.87), while gender was no longer associated (OR 1.53, 95 %CI 0.82 to 2.88). Conclusion Acceptability for flexible sigmoidoscopy and for FIT was high among Norwegian screening participants, though FIT participants were more willing to repeat screening. Women were less willing to repeat screening with flexible sigmoidoscopy compared to men. This gender difference seemed partly due to pain, and therefore preventable.This study is registered at ClinicalTrials.gov: NCT01538550.
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Affiliation(s)
- Benedicte Kirkøen
- Cancer Registry of Norway, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Edoardo Botteri
- Cancer Registry of Norway, Oslo, Norway.,National Advisory Unit for Women's Health, Women's Clinic, Oslo University Hospital, Oslo, Norway
| | | | - Jens Aksel Nilsen
- Department of Internal Medicine, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway
| | - Geir Hoff
- Cancer Registry of Norway, Oslo, Norway.,R&D Department, Telemark Hospital Trust, Skien, Norway.,Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Thomas de Lange
- Cancer Registry of Norway, Oslo, Norway.,Department of Internal Medicine, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,R&D Department, Vestfold Hospital Trust, Tønsberg, Norway
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33
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Knudsen MD, Berstad P, Hjartåker A, Gulichsen EH, Hoff G, de Lange T, Bernklev T, Botteri E. Lifestyle predictors for non-participation and outcome in the second round of faecal immunochemical test in colorectal cancer screening. Br J Cancer 2017; 117:461-469. [PMID: 28704841 PMCID: PMC5558680 DOI: 10.1038/bjc.2017.189] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 05/30/2017] [Accepted: 05/31/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To reduce colorectal cancer (CRC) mortality through population-based screening programmes using faecal tests, it is important that individuals continue to participate in the repeated rounds of screening. We aimed to identify lifestyle predictors for discontinuation of faecal immunochemical test (FIT) screening after the first round, as well as lifestyle predictors for colorectal neoplasia detected in the second-round FIT screening. METHODS In this longitudinal study, we invited 6959 individuals aged 50-74 years from south-east Norway for a first round of FIT screening and to complete a self-reported lifestyle questionnaire on demographic factors, body mass index (BMI, kg m-2), smoking habits, physical activity, consumption of alcohol and dietary items. Two years later, we estimated the associations between these factors, non-participation and screening results in the second round of FIT screening using adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Of the 3114 responders to the questionnaire who completed the first-round FIT and who were invited to participate in second-round FIT screening, 540 (17%) did not participate. The OR and (95% CI) for discontinuation of FIT screening after the first round was 1.61 (1.24-2.10) for current smoking compared with non-smoking; 2.01 (1.25-3.24) for BMI⩾35 kg m-2 compared with BMI 16.9-24.9 kg m-2 and 0.70 (0.52-0.94) for physical activity in the third quartile vs the first. Among participants, smoking, high BMI and high alcohol consumption were associated with an increased odds of detecting colorectal neoplasia (n=107). CONCLUSIONS These results may indicate that Norwegian FIT screening participants who discontinue after the first round have lifestyle behaviours associated with increased risk of CRC.
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Affiliation(s)
- Markus Dines Knudsen
- Department of Bowel cancer screening, Cancer Registry of Norway, P.O. Box 5313, Majorstuen, Oslo 0304, Norway
- Department of Research and Development, Telemark Hospital, Ulefosseveien 55, Skien 3710, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Blindern, P.O. Box 1046, Oslo 0317, Norway
| | - Paula Berstad
- Department of Bowel cancer screening, Cancer Registry of Norway, P.O. Box 5313, Majorstuen, Oslo 0304, Norway
| | - Anette Hjartåker
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Blindern, P.O. Box 1046, Oslo 0317, Norway
| | | | - Geir Hoff
- Department of Bowel cancer screening, Cancer Registry of Norway, P.O. Box 5313, Majorstuen, Oslo 0304, Norway
- Department of Research and Development, Telemark Hospital, Ulefosseveien 55, Skien 3710, Norway
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Blindern P.O. Box 1089, Oslo 0317, Norway
| | - Thomas de Lange
- Department of Bowel cancer screening, Cancer Registry of Norway, P.O. Box 5313, Majorstuen, Oslo 0304, Norway
- Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Sandvika, P.O. Box 800, Drammen 3004, Norway
| | - Tomm Bernklev
- Department of Research and Development, Telemark Hospital, Ulefosseveien 55, Skien 3710, Norway
- Institute of Clinical Medicine, University of Oslo, Blindern P.O. Box 1171, Oslo 0318, Norway
- Research and Development, Vestfold Hospital, Vestfold Hospital Trust, Tønsberg, P. O. 2168, Tønsberg 3103, Norway
| | - Edoardo Botteri
- Department of Bowel cancer screening, Cancer Registry of Norway, P.O. Box 5313, Majorstuen, Oslo 0304, Norway
- National Advisory Unit for Women's Health, Women’s Clinic, Oslo University Hospital, Oslo 0424, Norway
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Nostdahl T, Fredheim OM, Bernklev T, Doksrod TS, Mohus RM, Raeder J. A randomised controlled trial of propofol vs. thiopentone and desflurane for fatigue after laparoscopic cholecystectomy. Anaesthesia 2017; 72:864-869. [DOI: 10.1111/anae.13909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2017] [Indexed: 12/22/2022]
Affiliation(s)
- T. Nostdahl
- Department of Anaesthesiology; Telemark Hospital; Skien Norway
| | - O. M. Fredheim
- Department of Circulation and Medical Imaging; Faculty of Medicine; Norwegian University of Science and Technology; Trondheim Norway
- Centre of Palliative Medicine, Surgical Division; Akershus University Hospital; Lørenskog Norway
- National Competence Centre for Complex Symptom Disorders; Department of Pain and Complex Disorders; Trondheim Norway
| | - T. Bernklev
- Research and Development; Vestfold Hospital Trust; Tønsberg Norway
- Institute of Clinical Medicine; Medical Faculty; University of Oslo; Oslo Norway
| | - T. S. Doksrod
- Department of Anaesthesiology; Telemark Hospital; Skien Norway
| | - R. M. Mohus
- Department of Anaesthesiology; St. Olav University Hospital; Trondheim Norway
| | - J. Raeder
- Institute of Clinical Medicine; Medical Faculty; University of Oslo; Oslo Norway
- Department of Anaesthesiology; Oslo University Hospital; Oslo Norway
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Huppertz-Hauss G, Høivik ML, Jelsness-Jørgensen LP, Opheim R, Henriksen M, Høie O, Hovde Ø, Kempski-Monstad I, Solberg IC, Jahnsen J, Hoff G, Moum B, Bernklev T. Fatigue in a population-based cohort of patients with inflammatory bowel disease 20 years after diagnosis: The IBSEN study. Scand J Gastroenterol 2017; 52:351-358. [PMID: 27852169 DOI: 10.1080/00365521.2016.1256425] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Fatigue is a major concern for patients with ulcerative colitis (UC) and Crohn's disease (CD), but evidence from population-based studies regarding fatigue in long-standing inflammatory bowel disease (IBD) patients is scarce. Our aims were to assess fatigue scores and the prevalence of chronic fatigue in IBD patients 20 years after diagnosis and to identify variables associated with fatigue in this cohort. METHODS Twenty years after diagnosis, patients from a cohort with incident IBD were invited to a follow-up visit that included a structured interview, a clinical examination, laboratory tests and the Fatigue Questionnaire (FQ). Fatigue scores were obtained, and factors associated with fatigue were assessed via linear and logistic regression analyses. RESULTS Of the 599 invited patients, 440 (73.5%) completed the FQ. Among those with active disease, we found significantly higher fatigue scores than among those with quiescent disease (fatigue scores: UC 17.1 versus 12.4, p < .001, and CD 17.5 versus 13.3, p < .001). The fatigue scores of those with quiescent disease were comparable with those of the reference population. Chronic fatigue was more frequent among IBD patients than in the reference population. Factors associated with fatigue included self-perceived disease activity, poor sleep quality, anxiety and depression. CONCLUSION At 20 years after IBD diagnosis, fatigue scores were higher and chronic fatigue was more frequent among IBD patients with active disease than in the reference population and among those with quiescent IBD. Subjectively perceived disease activity, sleep quality, anxiety and depression were associated with fatigue in IBD patients.
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Affiliation(s)
| | - Marte Lie Høivik
- b Department of Gastroenterology , Oslo University Hospital Ullevål , Oslo , Norway
| | | | - Randi Opheim
- d Department of Gastroenterology , Oslo University Hospital Ullevål, and Institute of Health and Society, Faculty of Medicine, University of Oslo , Oslo , Norway
| | - Magne Henriksen
- e Department of Gastroenterology , Østfold Hospital Trust , Grålum , Norway
| | - Ole Høie
- f Department of Gastroenterology , Sørlandet Hospital , Arendal , Norway
| | - Øistein Hovde
- g Department of Gastroenterology , Innlandet Hospital Trust , Brumunddal , Norway
| | - Iril Kempski-Monstad
- h Department of Gastroenterology , Oslo University Hospital Ullevål , Oslo , Norway
| | | | - Jørgen Jahnsen
- i Department of Gastroenterology , Akershus University Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo , Oslo , Norway
| | - Geir Hoff
- j Department of Research and Development , Telemark Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo , Oslo , Norway
| | - Bjørn Moum
- k Department of Gastroenterology , Oslo University Hospital Ullevål, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo , Oslo , Norway
| | - Tomm Bernklev
- l Department of Research and Development , Vestfold Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo , Oslo , Norway
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Frigstad SO, Høivik M, Jahnsen J, Dahl SR, Cvancarova M, Grimstad T, Berset IP, Huppertz-Hauss G, Hovde Ø, Torp R, Bernklev T, Moum B, Jelsness-Jørgensen LP. Vitamin D deficiency in inflammatory bowel disease: prevalence and predictors in a Norwegian outpatient population. Scand J Gastroenterol 2017; 52:100-106. [PMID: 27603182 DOI: 10.1080/00365521.2016.1233577] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIM Vitamin D deficiency is common in inflammatory bowel disease (IBD). The aims of the present study were to determine the prevalence of vitamin D deficiency and to identify clinical and epidemiological variables associated with vitamin D deficiency in an outpatient population with IBD. METHODS Participants were recruited from nine hospitals in the southeastern and western regions of Norway as part of an observational, multicentre study from March 2013 to April 2014. Clinical and epidemiological data were collected by interview and from medical records. All analyses of serum 25-hydroxyvitamin D (25-OH-D) were performed in the same laboratory. RESULTS In total, 49% (200/408) of the patients had a 25-OH-D concentration <50 nmol/L, including 53% (122/230) of the Crohn's disease (CD) patients and 44% (78/178) of the ulcerative colitis (UC) patients. In CD patients, disease activity, measured as the HBI, was inversely associated with vitamin D deficiency. No such association was observed with the Simple Clinical Colitis Activity Index (SCCAI) scores in UC, but in UC patients, vitamin D deficiency was associated with elevated faecal calprotectin >100 mg/kg. In patients with CD, there were significantly more relapses during the previous year in patients with vitamin D deficiency. CONCLUSIONS Vitamin D deficiency was common, especially in CD, and was associated with increased disease activity, a relapsing disease course and higher inflammatory activity.
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Affiliation(s)
- Svein Oskar Frigstad
- a Department of Research , Østfold Hospital Trust , Grålum , Norway.,b Department of Medicine , Bærum Hospital, Vestre Viken Hospital Trust , Drammen , Norway.,c Institute of Clinical Medicine , University of Oslo , Norway
| | - Marte Høivik
- c Institute of Clinical Medicine , University of Oslo , Norway.,d Department of Gastroenterology , Oslo University Hospital , Oslo , Norway
| | - Jørgen Jahnsen
- c Institute of Clinical Medicine , University of Oslo , Norway.,e Department of Gastroenterology , Akershus University Hospital , Lørenskog , Norway
| | - Sandra Rinne Dahl
- f The Hormone Laboratory, Department of Medical Biochemistry , Oslo University Hospital , Oslo , Norway
| | - Milada Cvancarova
- c Institute of Clinical Medicine , University of Oslo , Norway.,g Department of Biostatistics , Oslo and Akershus University College , Oslo , Norway
| | - Tore Grimstad
- h Department of Gastroenterology , Stavanger University Hospital , Stavanger , Norway
| | | | - Gert Huppertz-Hauss
- j Department of Research and Development , Telemark Hospital Trust , Skien , Norway
| | - Øistein Hovde
- c Institute of Clinical Medicine , University of Oslo , Norway.,k Department of Medicine , Innlandet Hospital Trust , Gjøvik , Norway
| | - Roald Torp
- l Department of Medicine , Innlandet Hospital Trust , Hamar , Norway
| | - Tomm Bernklev
- c Institute of Clinical Medicine , University of Oslo , Norway.,m Department of Gastroenterology , Østfold Hospital Trust , Grålum , Norway
| | - Bjørn Moum
- c Institute of Clinical Medicine , University of Oslo , Norway.,d Department of Gastroenterology , Oslo University Hospital , Oslo , Norway
| | - Lars-Petter Jelsness-Jørgensen
- m Department of Gastroenterology , Østfold Hospital Trust , Grålum , Norway.,n Department of Health Sciences , Østfold University College , Fredrikstad , Norway
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Jensen Ø, Bernklev T, Jelsness-Jørgensen LP. Fatigue in type 1 diabetes: A systematic review of Observational studies. Diabetes Res Clin Pract 2017; 123:63-74. [PMID: 28002753 DOI: 10.1016/j.diabres.2016.11.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/04/2016] [Indexed: 01/10/2023]
Abstract
AIM To systematically review the literature on fatigue in people with type 1 diabetes. METHODS In the period from April to June 2015 and with an updated search in May 2016, eight electronic databases as well as the grey literature were searched. Studies of all types of design were included if they reported data on fatigue in adult people with type 1 diabetes. All studies were assessed for quality. RESULTS Out of 4259 references (including grey literature), 10 papers were reviewed in full. Three of these papers investigated fatigue as the primary endpoint, and one was assessed to be high quality. Two papers provided a definition of fatigue. Prevalence estimates ranged from 23 to 40%, dependent on the cut-off used. Six different questionnaires were used to measure fatigue/vitality and these were only validated to a limited extent in a diabetes population. Several demographic, personal and clinical factors were associated with fatigue, but the results were conflicting. CONCLUSIONS Few studies have been published that investigate fatigue in type 1 diabetes and there is a large variability in findings due to different measurement methods and factors investigated. There is still an unmet need to understand what contributes to fatigue in these patients through rigorous research.
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Affiliation(s)
- Øystein Jensen
- Østfold University College, Pb 770, 1757 Halden, Norway; Institute of Clinical Medicine, University of Oslo, Klaus Torgårds vei 3, 0372 Oslo, Norway.
| | - Tomm Bernklev
- Research and Development Department, Telemark Hospital Trust, Ulefossvegen, 3710 Skien, Norway; Institute of Clinical Medicine, University of Oslo, Klaus Torgårds vei 3, 0372 Oslo, Norway.
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Kirkøen B, Berstad P, Botteri E, Bernklev L, El-Safadi B, Hoff G, de Lange T, Bernklev T. Psychological effects of colorectal cancer screening: Participants vs individuals not invited. World J Gastroenterol 2016; 22:9631-9641. [PMID: 27920484 PMCID: PMC5116607 DOI: 10.3748/wjg.v22.i43.9631] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 09/19/2016] [Accepted: 10/10/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the possible long-term psychological harm of participating in colorectal cancer (CRC) screening in Norway.
METHODS In a prospective, randomized trial, 14294 participants (aged 50-74 years) were invited to either flexible sigmoidoscopy (FS) screening, or a faecal immunochemical test (FIT) (1:1). In total, 4422 screening participants (32%) completed the questionnaire, which consisted of the Hospital Anxiety and Depression Scale and the SF-12, a generic health-related quality of life (HRQOL) measurement, when invited to screening and one year after the invitation. A control group of 7650 individuals was invited to complete the questionnaire only, at baseline and one year after, and 1911 (25%) completed the questionnaires.
RESULTS Receiving a positive or negative screening result and participating in the two different screening modalities did not cause clinically relevant mean changes in anxiety, depression or HRQOL after one year. FS screening, but not FIT, was associated with an increased probability of being an anxiety case (score ≥ 8) at the one-year follow-up (5.6% of FS participants transitioned from being not anxious to anxious, while 3.0% experienced the reverse). This increase was moderately significantly different from the changes in the control group (in which the corresponding numbers were 4.8% and 4.5%, respectively), P = 0.06.
CONCLUSION Most individuals do not experience psychological effects of CRC screening participation after one year, while FS participation is associated with increased anxiety for a smaller group.
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Jelsness-Jørgensen LP, Bernklev T, Hovde Ø, Prytz Berset I, Huppertz-Hauss G, Moum B, Lie Høivik M. Patients' perceptions of quality of care and follow-up in inflammatory bowel disease. Scand J Gastroenterol 2016; 51:434-41. [PMID: 26635189 DOI: 10.3109/00365521.2015.1102319] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Quality of care (QoC) has gained increased attention in IBD. A better QoC has, historically, been linked to improved treatment outcomes. Even so, factors of equal importance to patients may be quality of life (QoL), patient-physician communication and access to care. Recent surveys suggest that IBD care in Europe is suboptimal. METHODS Patients were recruited from nine hospitals in the south-eastern and western part of Norway as a part of an observational, multicenter study In addition to clinical and socio-demographic factors; a purposely designed 26 item questionnaire was used to quantify aspects related to IBD care, including QoC. Moreover, the Fatigue Questionnaire (FQ) was used to investigate fatigue. RESULTS In total, 411 patients were included. Of these, 231 were diagnosed with CD and 180 with UC. Furthermore, 86.1% (354/411) were satisfied with the quality of IBD follow-up and only 4.1% (17/411) were dissatisfied. Most dissatisfaction was related to: lack of focus on personal relations (18.2%), HRQoL (15.1%), general practitioner knowledge of IBD (13.9%), ability to talk about important topics (7.8%), and hospital discharge communication (9.4%). Higher age and longer disease duration was associated with improved QoC scores in both UC and CD. Fatigue was associated with decreased QoC scores in both diagnoses. CONCLUSIONS Patients are satisfied with quality of care in IBD. However, communication seems to be an important area of improvement - not only related to patient-physician communication, but also to transitional communication between different health-care levels.
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Affiliation(s)
- Lars-Petter Jelsness-Jørgensen
- a Østfold University College, Health Science , Halden , Norway ;,b Department of Gastroenterology, Østfold University College, Health Science/Østfold Hospital Trust , Fredrikstad , Norway
| | - Tomm Bernklev
- c Department of Research , Telemark Hospital Trust , Skien , Norway
| | - Øistein Hovde
- d Institute of Clinical Medicine, University of Oslo , Nydalen , Oslo , Norway ;,e Department of Gastroenterology , Innlandet Hospital Trust , Gjøvik , Norway
| | - Ingrid Prytz Berset
- f Department of Gastroenterology , Møre and Romsdal Hospital Trust Ålesund , Ålesund , Norway
| | | | - Bjørn Moum
- h Department of Gastroenterology/University of Oslo , Oslo University Hospital, Institute of Clinical Medicine , Nydalen , Oslo , Norway
| | - Marte Lie Høivik
- i Department of Gastroenterology , Oslo University Hospital , Nydalen , Oslo , Norway
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Jelsness-Jørgensen LP, Frigstad SO, Moum B, Grimstad T, Opheim R, Jahnsen J, Bernklev T. Pain may be an important factor to consider in inflammatory bowel disease patients troubled by fatigue. United European Gastroenterol J 2016; 5:687-693. [PMID: 28815032 DOI: 10.1177/2050640616674654] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 09/20/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Pain has been associated with fatigue in many chronic diseases, but data are not available for inflammatory bowel disease (IBD). The aim of this study was to investigate whether fatigue is associated with pain in IBD after adjusting for the relevant covariates. METHODS Participants were recruited from nine hospitals in the south-eastern and western part of Norway. Socio-demographic variables were self-reported by patients. Disease activity was assessed by disease activity indices and faecal calprotectin. Patient-reported outcomes (PROs) were collected using the Fatigue Questionnaire (FQ), Brief Pain Inventory (BPI), Hospital Anxiety and Depression Scale (HADS) and Basic Nordic Sleep Questionnaire. RESULTS From a total of 452 invited patients, 414 (91.6%) provided written informed consent. After excluding any missing data, 408 total patients were included in the analyses (ulcerative colitis = 180 and Crohn's disease = 228). In the crude analysis, substantial and chronic fatigue were associated with increased pain intensity regardless of the diagnosis. However, when controlling for relevant covariates in the ANCOVA, the differences in pain intensity among patients with and without substantial or chronic fatigue were insignificant. The Cohen's d effect size was small to moderate (>0.20) in patients with chronic fatigue. CONCLUSIONS Despite a tendency of elevated pain intensity scores among patients with fatigue, these differences were insignificant after controlling for the relevant covariates. However, based on Cohen's effect size, these differences may be of clinical importance in a subset of patients.
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Affiliation(s)
- Lars-Petter Jelsness-Jørgensen
- Østfold University College, Department of Health Sciences/Østfold Hospital Trust, Department of Gastroenterology, Fredrikstad, Norway
| | - Svein-Oskar Frigstad
- Vestre Viken Hospital Trust, Department of Gastroenterology/Østfold Hospital Trust, Department of Internal Medicine, Norway
| | - Bjørn Moum
- Oslo University Hospital, Department of Gastroenterology/University of Oslo, Oslo, Norway
| | - Tore Grimstad
- Stavanger University Hospital, Department of Gastroenterology, Stavanger, Norway
| | - Randi Opheim
- Oslo University Hospital, Department of Gastroenterology/University of Oslo, Oslo, Norway
| | - Jørgen Jahnsen
- Akershus University Hospital, Department of Gastroenterology, Lørenskog, Norway; University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Tomm Bernklev
- Telemark Hospital Trust, Department of Research/University of Oslo, Skien, Norway
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Knudsen MD, de Lange T, Botteri E, Nguyen DH, Evensen H, Steen CB, Hoff G, Bernklev T, Hjartåker A, Berstad P. Favorable lifestyle before diagnosis associated with lower risk of screen-detected advanced colorectal neoplasia. World J Gastroenterol 2016; 22:6276-86. [PMID: 27468217 PMCID: PMC4945986 DOI: 10.3748/wjg.v22.i27.6276] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 05/23/2016] [Accepted: 06/13/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the association between adherence to health recommendations and detection of advanced colorectal neoplasia (ACN) in colorectal cancer (CRC) screening. METHODS A total of 14832 women and men were invited to CRC screening, 6959 in the fecal immunochemical test arm and 7873 in the flexible sigmoidoscopy arm. These were also sent a self-reported lifestyle questionnaire to be completed prior to their first CRC screening. A lifestyle score was created to reflect current adherence to healthy behaviors in regard to smoking, body mass index, physical activity, alcohol consumption and food consumption, and ranged from zero (poorest) to six (best). Odds ratios (ORs) and 95%CIs were calculated using multivariable logistic regression to evaluate the association between the single lifestyle variables and the lifestyle score and the probability of detecting ACN. RESULTS In all 6315 women and men completed the lifestyle questionnaire, 3323 (53%) in the FIT arm and 2992 (47%) in the FS arm. This was 89% of those who participated in screening. ACN was diagnosed in 311 (5%) participants of which 25 (8%) were diagnosed with CRC. For individuals with a lifestyle score of two, three, four, and five-six, the ORs (95%CI) for the probability of ACN detection were 0.82 (0.45-1.16), 0.43 (0.28-0.73), 0.41 (0.23-0.64), and 0.41 (0.22-0.73), respectively compared to individuals with a lifestyle score of zero-one. Of the single lifestyle factors, adherence to non-smoking and moderate alcohol intake were associated with a decreased probability of ACN detection compared to being a smoker or having a high alcohol intake 0.53 (0.42-0.68) and 0.63 (0.43-0.93) respectively. CONCLUSION Adopted healthy behaviors were inversely associated with the probability of ACN detection. Lifestyle assessment might be useful for risk stratification in CRC screening.
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Jelsness-Jørgensen LP, Moum B, Grimstad T, Jahnsen J, Opheim R, Prytz Berset I, Hovde Ø, Torp R, Frigstad SO, Huppertz-Hauss G, Bernklev T. Validity, Reliability, and Responsiveness of the Brief Pain Inventory in Inflammatory Bowel Disease. Can J Gastroenterol Hepatol 2016; 2016:5624261. [PMID: 27446848 PMCID: PMC4930809 DOI: 10.1155/2016/5624261] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 04/24/2016] [Accepted: 05/29/2016] [Indexed: 01/24/2023] Open
Abstract
Background and Aims. No patient-reported outcome measures targeting pain have yet been validated for use in IBD patients. Consequently, the aim of this study was to test the psychometrical properties of the brief pain inventory (BPI) in an outpatient population with IBD. Methods. Participants were recruited from nine hospitals in the southeastern and western parts of Norway. Clinical and sociodemographic data were collected, and participants completed the BPI, as well as the Short-Form 36 (SF-36). Results. In total, 410 patients were included. The BPI displayed high correlations with the bodily pain dimension of the SF-36, as well as moderate correlations with disease activity indices. The BPI also displayed excellent internal consistency (Cronbach's alpha value of 0.91, regardless of diagnosis) and good to excellent test-retest values (intraclass correlation coefficient (ICC) 0.84-0.90 and Kappa values > .70). In UC, calculation of responsiveness revealed that only BPI interference in patients reporting improvement reached the threshold of 0.2. In CD, Cohen's d ranged from 0.26 to 0.68. Conclusions. The BPI may serve as an important supplement in patient-reported outcome measurement in IBD. There is need to confirm responsiveness in future studies. Moreover, responsiveness should ideally be investigated using changes in objective markers of inflammation.
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Affiliation(s)
- Lars-Petter Jelsness-Jørgensen
- Health Science, Østfold University College, Postboks 700, 1757 Halden, Norway
- Department of Gastroenterology, Østfold Hospital Trust, Fredrikstad, Norway
| | - Bjørn Moum
- Department of Gastroenterology, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Postboks 1072 Blindern, 0316 Oslo, Norway
| | - Tore Grimstad
- Department of Gastroenterology, Stavanger University Hospital, Armauer Hansensvei 20, 4011 Stavanger, Norway
| | - Jørgen Jahnsen
- Institute of Clinical Medicine, University of Oslo, Postboks 1072 Blindern, 0316 Oslo, Norway
- Department of Gastroenterology, Akershus University Hospital, Postboks 1000, 1478 Lørenskog, Norway
| | - Randi Opheim
- Department of Gastroenterology, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway
- Institute of Health and Society, University of Oslo, Postboks 1072 Blindern, 0316 Oslo, Norway
| | - Ingrid Prytz Berset
- Department of Gastroenterology, Møre and Romsdal Hospital Trust, 6026 Ålesund, Norway
| | - Øistein Hovde
- Institute of Clinical Medicine, University of Oslo, Postboks 1072 Blindern, 0316 Oslo, Norway
- Department of Gastroenterology, Innlandet Hospital Trust, Kyrre Grepps Gate 11, 2819 Gjøvik, Norway
| | - Roald Torp
- Department of Gastroenterology, Innlandet Hospital Trust, Postboks 104, 2381 Brumunddal, Norway
| | - Svein Oskar Frigstad
- Department of Gastroenterology, Vestre Viken Hospital Trust, Postboks 800, 3004 Drammen, Norway
- Department of Internal Medicine, Østfold Hospital Trust, Postboks 300, 1714 Grålum, Norway
| | | | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, Postboks 1072 Blindern, 0316 Oslo, Norway
- O&U, Telemark Hospital Trust, 3710 Skien, Norway
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Kirkøen B, Berstad P, Botteri E, Åvitsland TL, Ossum AM, de Lange T, Hoff G, Bernklev T. Do no harm: no psychological harm from colorectal cancer screening. Br J Cancer 2016; 114:497-504. [PMID: 26867161 PMCID: PMC4782205 DOI: 10.1038/bjc.2016.14] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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] [Received: 11/18/2015] [Revised: 12/21/2015] [Accepted: 01/11/2016] [Indexed: 12/13/2022] Open
Abstract
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.
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Affiliation(s)
- Benedicte Kirkøen
- Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, P.O. box 1171 Blindern, 0318 Oslo, Norway
| | - Paula Berstad
- Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.,Department of Research and Development, Telemark Hospital Trust, 3710 Skien, Norway
| | - Edoardo Botteri
- Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.,Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Tone Lise Åvitsland
- Department of Internal Medicine, Vestre Viken Hospital Trust, Bærum Hospital, P.O. box 800, 3004 Drammen, Norway
| | - Alvilde Maria Ossum
- Department of Gastroenterology, Østfold Hospital Trust, P.O. box 300, 1714 Grålum, Norway
| | - Thomas de Lange
- Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.,Department of Internal Medicine, Vestre Viken Hospital Trust, Bærum Hospital, P.O. box 800, 3004 Drammen, Norway
| | - Geir Hoff
- Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.,Department of Research and Development, Telemark Hospital Trust, 3710 Skien, Norway.,Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, P.O. box 1089 Blindern, 0318 Oslo, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, P.O. box 1171 Blindern, 0318 Oslo, Norway.,Department of Research and Development, Telemark Hospital Trust, 3710 Skien, Norway
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Lønning K, Bernklev T, Midtvedt K, Andersen M, Heldal K. O-076: Health related quality of life (HRQOL) in older patients waiting for kidney transplantation in Norway. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30089-9] [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: 10/23/2022]
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Andersen RD, Bernklev T, Langius-Eklöf A, Nakstad B, Jylli L. The COMFORT behavioural scale provides a useful assessment of sedation, pain and distress in toddlers undergoing minor elective surgery. Acta Paediatr 2015; 104:904-9. [PMID: 25980339 DOI: 10.1111/apa.13045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 03/27/2015] [Accepted: 05/13/2015] [Indexed: 11/30/2022]
Abstract
AIM The COMFORT behavioural scale was developed to assess sedation, pain and distress in children unable to report pain. Our aims were to test construct validity of the scale in toddlers undergoing minor surgery and determine the inter-rater reliability of the scale. METHODS We consecutively enrolled 45 children aged 12-36 months from a Norwegian surgical outpatient care unit. The level of sedation, pain and distress was assessed before and after surgery with the COMFORT behavioural scale. Inter-rater reliability was estimated and construct validity was tested based on a priori defined hypotheses. A 2.5-point (15%) change in the scale was considered clinically important. RESULTS We obtained 307 scores covering most of the scale's range, but a floor effect was clearly present. Inter-rater reliability was high between assessors (intraclass correlation coefficient = 0.96; 95% CI 0.92-0.98). Clinically important differences were seen between baseline and light sedation (3.1 points, p < 0.001) and between light and deep sedation (4.6 points, p = 0.002). The difference between baseline and our definition of a pain/distress state was not clinically important (1.5 points, p = 0.039). CONCLUSION The COMFORT behavioural scale can provide one aspect of an overall clinical assessment of sedation, and probably pain and distress, in toddlers before and after surgery.
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Affiliation(s)
- Randi Dovland Andersen
- Department of Child and Adolescent Health Services; Telemark Hospital; Skien Norway
- Division of Nursing; Department of Neurobiology, Care Sciences and Society; Karolinska Institute; Stockholm Sweden
| | - Tomm Bernklev
- Department of Research; Telemark Hospital; Skien Norway
| | - Ann Langius-Eklöf
- Division of Nursing; Department of Neurobiology, Care Sciences and Society; Karolinska Institute; Stockholm Sweden
| | - Britt Nakstad
- Department of Pediatric and Adolescent Medicine; Akershus University Hospital; Lørenskog Norway
| | - Leena Jylli
- Department of Clinical Science, Intervention and Technology; Karolinska Institute; Stockholm Sweden
- Department of Anesthesia and Intensive Care; Karolinska University Hospital Huddinge; Huddinge Sweden
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Isene R, Bernklev T, Høie O, Munkholm P, Tsianos E, Stockbrügger R, Odes S, Palm Ø, Småstuen M, Moum B. Extraintestinal manifestations in Crohn's disease and ulcerative colitis: results from a prospective, population-based European inception cohort. Scand J Gastroenterol 2015; 50:300-5. [PMID: 25535653 DOI: 10.3109/00365521.2014.991752] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND In chronic inflammatory bowel disease (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]), symptoms from outside the gastrointestinal tract are frequently seen, and the joints, skin, eyes, and hepatobiliary area are the most usually affected sites (called extraintestinal manifestations [EIM]). The reported prevalence varies, explained by difference in study design and populations under investigation. The aim of our study was to determine the prevalence of EIM in a population-based inception cohort in Europe and Israel. METHODS IBD patients were incepted into a cohort that was prospectively followed from 1991 to 2004. A total of 1145 patients were followed for 10 years. RESULTS The cumulative prevalence of first EIM was 16.9% (193/1145 patients) over a median follow-up time of 10.1 years. Patients with CD were more likely than UC patients to have immune-mediated (arthritis, eye, skin, and liver) manifestations: 20.1% versus 10.4% (p < 0.001). Most frequently seen was arthritis which was significantly more common in CD (12.9%) than in UC (8.1%), p = 0.01. Pan-colitis compared to proctitis in UC increased the risk of EIM. CONCLUSION In a European inception cohort, EIMs in IBD were consistent with that seen in comparable studies. Patients with CD are twice as likely as UC patients to experience EIM, and more extensive distribution of inflammation in UC increases the risk of EIM.
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Affiliation(s)
- Rune Isene
- Department of Gastroenterology, Oslo University Hospital , Oslo , Norway
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Isene R, Bernklev T, Høie O, Langholz E, Tsianos E, Stockbrügger R, Odes S, Småstuen M, Moum B. Thromboembolism in inflammatory bowel disease: results from a prospective, population-based European inception cohort. Scand J Gastroenterol 2014; 49:820-5. [PMID: 24754745 DOI: 10.3109/00365521.2014.910545] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Patients with inflammatory bowel disease (IBD) have proven an increased risk of venous thromboembolism (VTE), particularly when hospitalized. The estimate of the true risk varies considerably between studies, primarily due to differences in methodology. We set out to determine the incidence of VTE in a population-based European inception cohort. METHODS IBD patients were incepted into a cohort that was prospectively followed from the early 1990s to the early 2000s. A total of 1145 patients were followed for a total of 10,634 patient-years (p.y.). RESULTS A total of 19 thromboembolic events were identified - 13 deep vein thrombosis and 6 with pulmonary embolism. The incidence rate of VTE was 1.8 per 1000 p.y. CONCLUSION The risk of VTE was elevated in this IBD cohort but lower than previously reported. The highest risk was seen in hospitalized patients, but corticosteroids-requiring disease in outpatients also conferred some risk.
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Affiliation(s)
- Rune Isene
- Department of Gastroenterology, Oslo University Hospital , Oslo , Norway
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Van Londen M, Humalda JK, Aarts BM, Sanders JS, Bakker SJL, Navis GJ, De Borst MH, Pazik J, O Dak M, Lewandowski Z, Podgorska M, Sadowska A, Sitarek E, Malejczyk J, Durlik M, Drechsler C, Philstrom H, Meinitzer A, Pilz S, Tomaschitz A, Abedini S, Fellstrom B, Jardine A, Wanner C, Maerz W, Holdaas H, Halleck F, Staeck O, Neumayer HH, Budde K, Khadzhynov D, Rostaing L, Allal A, Congy N, Aarninck A, Del Bello A, Maggioni S, Debiols B, Sallusto F, Kamar N, Stolyarevich E, Artyukhina L, Kim I, Tomilina N, Zaidenov V, Kurenkova L, Keyzer CA, De Borst MH, Van Den Berg E, Jahnen-Dechent W, Navis G, Bakker SJL, Van Goor H, Pasch A, Aulagnon F, Avettand-Fenoel V, Scemla A, Lanternier F, Lortholary O, Anglicheau D, Legendre C, Zuber J, Furic-Cunko V, Basic-Jukic N, Coric M, Kastelan Z, Hudolin T, Kes P, Mikolasevic I, Racki S, Lukenda V, Orlic L, Dobrowolski LC, Verberne HJ, Ten Berge IJM, Bemelman FJ, Krediet CTP, Ferreira AC, Silva C, Remedio F, Pena A, Nolasco F, Heldal K, Lonning K, Leivestad T, Reisaeter AV, Hartmann A, Foss AE, Midtvedt K, Vlachopanos G, Kassimatis T, Zerva A, Kokkona A, Stavroulaki E, Agrafiotis A, Sanchez Sobrino B, Lafuente Covarrubias O, Karsten Alvarez S, Zalamea Jarrin F, Rubio Gonzalez E, Huerta Arroyo A, Portoles Perez J, Basic-Jukic N, Kes P, Baek CH, Kim M, Kim JS, Yang WS, Han DJ, Park SK, Zulkarnaev A, Vatazin A, Cabiddu G, Maxia S, Castellino S, Loi V, Guzzo G, Piccoli GB, Pani A, Bucsa C, Tacu D, Harza M, Sinescu I, Mircescu G, Stefan G, Alfieri CM, Laura F, Danilovic B, Cresseri D, Meneghini M, Riccardo F, Regalia A, Messa P, Panuccio V, Tripepi R, Parlongo G, Quattrone S, Leonardis D, Tripepi G, Zoccali C, Mallamaci F, Amer H, Geerdes PA, Fettes TT, Prieto M, Walker RC, Edwards BS, Cosio FG, Khrabrova M, Nabokov A, Groene HJ, Weithofer P, Kliem V, Smirnov A, Dobronravov V, Sezer S, Gurlek Demirci B, Tutal E, Guliyev O, Say N CB, Ozdemir Acar FN, Haberal M, Albugami MM, Hussein M, Alsaeed S, Almubarak A, Bel'eed-Akkari K, Go biewska JE, Tarasewicz A, D bska- lizie A, Rutkowski B, Albugami MM, Hussein M, Almubarak A, Alsaeed S, Bel'eed-Akkari K, Ailioaie O, Arzouk N, Tourret J, Mercadal L, Szumilak D, Ourahma S, Parra J, Billault C, Barrou B, Alfieri CM, Floreani R, Ulivieri FM, Meneghini M, Regalia A, Zanoni F, Croci D, Rastaldi MP, Messa PG, Keyzer CA, Riphagen IJ, Joosten MM, Navis G, Muller Kobold AC, Kema IP, Bakker SJL, De Borst MH, Santos Lascasas J, Malheiro J, Fonseca I, Martins L, Almeida M, Pedroso S, Dias L, Henriques A, Cabrita A, Vincenti F, Weir M, Von Visger J, Kopyt N, Mannon R, Deng H, Yue S, Wolf M, Halleck F, Khadzhynov, D, Schmidt D, Petereit F, Slowinski T, Neumayer HH, Budde K, Staeck O, Hernandez Vargas H, Artamendi Larranaga M, Gil Catalinas F, Ramalle Gomara E, Bello Ovalle A, Pimentel Guzman G, Coloma Lopez A, Dall Anesse C, Gil Paraiso A, Beired Val I, Sierra Carpio M, Huarte Loza E, Slubowska K, Szmidt J, Chmura A, Durlik M, Staeck O, Khadzhynov D, Schmidt D, Niemann M, Petereit F, Lachmann N, Neumayer HH, Budde K, Halleck F, Alotaibi T, Nampoory N, Gheith O, Halim M, Aboatteya H, Mansour H, Abdulkawey H, Said T, Nair P, WazNa-Jab O Ska E, Durlik M, Elias M, Caillard S, Morelon E, Rivalan J, Moal V, Frimat L, Mourad G, Rerolle JP, Legendre C, Mousson C, Delahousse M, Pouteil-Noble C, Dantal J, Cassuto E, Subra JF, Lang P, Thervet E, Roosweil D, Molnar MZ, Fornadi K, Ronai KZ, Novak M, Mucsi I, Scale TM, Robertson S, Kumwenda M, Jibani M, Griffin S, Williams AJ, Mikhail A, Jeong JC, Koo TY, Jeon HJ, Han M, Oh KH, Ahn C, Yang J, Bancu I, Canas L, Juega J, Malumbres S, Guermah I, Bonet J, Lauzurica R, Basso E, Messina M, Daidola G, Mella A, Lavacca A, Manzione AM, Rossetti M, Ranghino A, Ariaudo C, Segoloni GP, Biancone L, Whang E, Son SH, Kwon H, Kong JJ, Choi WY, Yoon CS, Ferreira AC, Silva C, Aires I, Ferreira A, Remedio F, Nolasco F, Ratkovic M, Basic Jukic N, Gledovic B, Radunovic D, Prelevic V, Stefan G, Garneata L, Bucsa C, Harza M, Sinescu I, Mircescu G, Tacu D, Aniort J, Kaysi S, Mulliez A, Heng AE, Su owicz J, Wojas-Pelc A, Ignacak E, Janda K, Krzanowski M, Miarka P, Su owicz W, Filipov JJ, Zlatkov BK, Dimitrov EP, Svinarov DA, Champion L, Renoux C, Randoux C, Du Halgouet C, Azeroual L, Glotz D, Vrtovsnik F, Daugas E, Musetti C, Battista M, Cena T, Izzo C, Airoldi A, Magnani C, Stratta P, Fiskvik I, Holte H, Bentdal O, Holdaas H, Erkmen Uyar M, Sezer S, Bal Z, Guliyev O, Colak T, Gurlek Demirci B, Ozdemir Acar N, Haberal M, Kara E, Ahbap E, Basturk T, Koc Y, Sakaci T, Sahutoglu T, Akgol C, Sevinc M, Unsal A, Seyahi N, Abdultawab K, Alotaibi T, Gheith O, Mansour H, Halim M, Nair P, Said T, Balaha M, Elsayed A, Awadeen W, Nampoory N, Hwang JC, Jiang MY, Lu YH, Weng SF, Madziarska K, Zmonarski SC, Augustyniak-Bartosik H, Magott-Procelewska M, Krajewska M, Mazanowska O, Banasik M, Penar J, Weyde W, Boraty Ska M, Klinger M, Swarnalatha G, Narendranath L, Shanta Rao G, Sawhney A, Subrahmanyam L, Kumar S, Jeon H, Hakim A, Patel U, Shrivastava S, Banerjee D, Kimura T, Yagisawa T, Nanmoku K, Kurosawa A, Sakuma Y, Miki A, Nukui A, Lee CH, Oh IH, Park JS, Watarai Y, Narumi S, Goto N, Hiramitsu T, Tsujita M, Yamamoto T, Kobayashi T, Muniz Pacios L, Molina M, Cabrera J, Gonzalez E, Garcia Santiago A, Aunon P, Santana S, Polanco N, Gutierrez E, Jimenez C, Andres A, Mohammed M, Hammam M, Housawi A, Goldsmith DJ, Cronin A, Frame S, Smalcelj R, Canoz MB, Yavuz DD, Altunoglu A, Yavuz R, Colak T, Haberal M, Tong A, Hanson CS, Chapman JR, Halleck F, Budde K, Papachristou C, Craig J, Zheng XY, Han S, Wang LM, Zhu YH, Zeng L, Zhou MS, Guliyev O, Erkmen Uyar M, Sezer S, Bal Z, Colak T, Gurlek Demirci B, Ozdemir Acar N, Haberal M, Ranghino A, Diena D, De Rosa FG, Faletti R, Barbui AM, Guarnaccia C, Corcione S, Messina M, Ariaudo C, Segoloni GP, Biancone L, Patel R, Murray PD, Moiseev A, Kalachik A, Harden PN, Norby G, Mjoen G, Holdaas H, Gilboe IM, Shi Y, Luo L, Cai B, Wang T, Tao Y, Wang L, Erkmen Uyar M, Sezer S, Bal Z, Guliyev O, Tutal E, Gurlek Demirci B, Ozdemir Acar N, Haberal M, Di Vico MC, Messina M, Mezza E, Giraudi R, Nappo A, Boaglio E, Ranghino A, Fop F, Segoloni GP, Biancone L, Carta P, Dattolo E, Buti E, Zanazzi M, Villari D, Di Maria L, Santoro G, Li Marzi V, Minetti EE, Nicita G, Carta P, Zanazzi M, Buti E, Antognoli G, Dervishi E, Vignali L, Caroti L, Di Maria L, Minetti EE, Dorje C, Kovacevic G, Hammarstrom C, Strom EH, Holdaas H, Midtvedt K, Reisaeter AV, Alfieri CM, Floreani R, Meneghini M, Regalia A, Zanoni F, Vettoretti S, Croci MD, Rastaldi MP, Messa P, Heldal K, Lonning K, Reisaeter AV, Bernklev T, Midtvedt K, Strakosha A, Pasko N, Nasto F, Cadri V, Dedei A, Thereska N. TRANSPLANTATION CLINICAL 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Opheim R, Fagermoen MS, Bernklev T, Jelsness-Jorgensen LP, Moum B. Fatigue interference with daily living among patients with inflammatory bowel disease. Qual Life Res 2013; 23:707-17. [PMID: 23975381 DOI: 10.1007/s11136-013-0508-4] [Citation(s) in RCA: 19] [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] [Accepted: 08/09/2013] [Indexed: 12/31/2022]
Abstract
PURPOSE The purpose of the study was to examine fatigue interference with daily living in patients with inflammatory bowel disease (IBD) and to explore relationships between severe fatigue interference and socio-demographic and clinical variables, including use of complementary and alternative medicine (CAM). METHODS Data were collected using self-report questionnaires from adult IBD outpatients. Fatigue interference was assessed with the 5-item Fatigue Severity Scale, and scores ≥ 5 were defined as severe fatigue interference. CAM use was assessed with the International CAM Questionnaire. Multivariate logistic regression analysis was used to examine associations between severe fatigue interference and socio-demographic factors, clinical factors, and CAM use. RESULTS In total, 428 patients had evaluable questionnaires (response rate 93 %). Severe fatigue interference was reported by 39 % of the total sample. Patients with Crohn's disease (CD) (n = 238) were more likely than patients with ulcerative colitis (UC) (n = 190) to report severe fatigue interference (43 and 33 %, respectively, p = 0.003). In addition, patients reporting severe fatigue interference were more likely to have active disease than patients without severe fatigue interference (p < 0.001 for both diagnoses). Patients with inactive disease had scores comparable to the general population. Factors independently associated with severe fatigue interference in UC included disease activity and CAM use, while in CD they included disease activity and current smoking. CONCLUSIONS Severe fatigue interference is common among IBD patients with active disease. Among patients with UC, but not CD, CAM use was associated with severe fatigue interference. The relationship between fatigue interference and personal factors should be considered further in subsequent studies.
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Affiliation(s)
- Randi Opheim
- Division of Medicine, Department of Gastroenterology, Oslo University Hospital, Nydalen, P.O. Box 4956, 0424, Oslo, Norway,
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Høivik ML, Moum B, Solberg IC, Henriksen M, Cvancarova M, Bernklev T. Work disability in inflammatory bowel disease patients 10 years after disease onset: results from the IBSEN Study. Gut 2013; 62:368-75. [PMID: 22717453 DOI: 10.1136/gutjnl-2012-302311] [Citation(s) in RCA: 169] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To compare the work disability (WD) rate in inflammatory bowel disease (IBD) patients 10 years after disease onset, with the WD rate in the background population,and to assess whether clinical or demographic factors in the early disease course could predict WD after 10 years disease. DESIGN A large, population-based inception cohort (the Inflammatory Bowel in South Eastern Norway cohort) was prospectively followed up at 1, 5 and 10 years after diagnosis. At the 10-year follow-up data on WD were collected. Data on disability pension (DP) in the background population were retrieved from public databases. We calculated overall and age-standardised relative risks (RR) for DP. Logistic regression analysis was used to examine predictive factors. RESULTS A total of 518 patients completed the 10-year follow-up (response rate 83.5%). The overall disability rate in the IBD population was 18.8%, and the RR was 1.8 (95% CI 1.4 to 2.3) for ulcerative colitis (UC) and 2.0 (95% CI 1.4 to 2.7) for Crohn's disease (CD). The RR for DP was highest in patients aged below 40 years while patients aged over 60 years had no increased RR. Steroid treatment at the 1-year follow-up predicted WD after 10 years disease in both CD and UC. In UC, increased C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) at diagnosis, early colectomy, and more than two relapses during the first year of the disease also predicted WD. CONCLUSION Ten years after disease onset IBD patients had an increased RR for DP as compared with the background population. The youngest patients had the highest RR. Markers of severe disease course predicted WD.
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Affiliation(s)
- Marte Lie Høivik
- Division of Medicine, Department of Gastroenterology, Oslo University Hospital, Aker, P.O Box 4959 Nydalen, 0424 Oslo, Norway.
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