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Biomedical subjects

B Valen

Publications and source records attributed to B Valen.

18 recordsLinked to original sources
PubMed2001

[Luxation of hip prosthesis].

BACKGROUND: Our aim was to elucidate the dislocation rate after total hip arthroplasty at Haugesund County Hospital, Norway. MATERIAL AND METHODS: Information was obtained from the Norwegian Arthroplasty Register and from hospital patient files. All 1,076 patients (781 female) operated at the hospital 1987-2000 were included. The ITH prosthesis was used in 545 patients and the Charnley prosthesis with a smaller head in 531 patients. RESULTS: 21 patients (2.0%) experienced dislocation after total hip arthroplasty, 17 during activities of daily living and three after a fall. 17 dislocations happened within six months postoperatively. The dislocation risk was smaller for women than for men (1.3% vs 3.7%, p = 0.01). Patients with a Charnley prosthesis had a greater risk for recurrent luxations than those with a ITH prosthesis (1.7% vs 0.2%, p = 0.01). INTERPRETATION: The rate of dislocation after total hip arthroplasty in this study is similar to that of other reports in the literature.

Adult↗
PubMed2000

[Long term effects o gastric banding for weight reduction].

BACKGROUND: Obesity is defined as body weight exceeding normal weight by 30%, or a body mass index (BMI) > 30. Various surgical procedures have been introduced to treat obesity. Gastric banding is a variant of the gastroplastic method. Our aim was to study the long term effect of this procedure. MATERIAL AND METHODS: Over the years 1982 to 1988, gastric banding was performed at the county hospital of Haugesund in 26 patients with a mean age of 35.7 years and a mean preoperative BMI of 41.2. Data were obtained from patient files and from questionnaires returned by 24 patients, on average 14 years after the operation. RESULTS: Mean BMI for 16 patients with an intact banding device at follow-up was 35.2. Mean weight reduction was 15 kilograms. 58% of the patients regretted the procedure. Only a few were completely satisfied. INTERPRETATION: Long term results of gastric banding are not satisfactory.

Adult↗
PubMed2000

[Laminectomy for degenerative spinal stenosis].

BACKGROUND: Our aim was to find quality indicators like frequency of complications and reoperations in addition to post-operative status and patient satisfaction. MATERIAL AND METHODS: 57 patients underwent a follow-up after 5.8 years on average. Most were female and mean age at operation was 60.8 years. Information was obtained from patient records and questionnaires returned by 88.7% of 53 remaining patients. RESULTS: The perioperative complication rate was 15.8%. Most were light and there was no mortality. Six out of ten patients were satisfied, whereas one of three was not. One out of eight regretted the procedure. Postoperatively three out of five reported a persistent but usually light back problem; the majority of these patients were satisfied. One out of four had changed to less strenuous work; near half of the patients had qualified for a permanent disability pension. Three patients had been reoperated. INTERPRETATION: Our results compare well with other studies, which are reported and briefly discussed.

Adult↗
PubMed1999

[Persistent back pain, working situation and disability pension after lumbago surgery].

373 patients who underwent lumbar disc surgery at our department were submitted to a follow-up after 2-17 years. The aim of our study was to find quality indicators: absence of complications, postoperative status including work capacity, and patient satisfaction Questionnaires were returned by 95% of the patients and showed that 58% had a persistent but usually light back problem. 23% had changed to less strenuous work and 13% had qualified for a permanent disability pension. These two groups had significantly higher rates of recurrences and reoperations and were significantly less satisfied. We found no significant relationship between these two groups and a strenuous occupation, nor did we find any gender disparity. Those who qualified for a permanent disability pension were significantly older than the rest of the patients. Our results compare well with other reports.

Adolescent↗
PubMed1999

[Coccygectomy for coccygodynia].

Treatment of coccygodynia is primarily conservative and symptomatic. Operative treatment is controversial and the results are confusing. A thorough examination including X-rays is recommended in order to exclude other diseases. We undertook a follow-up of 26 patients 1-16 years after coccygectomy for coccygodynia. The aim was to elucidate the long term result including rate of patient satisfaction. We used patients records and questionnaires. 25 patients answered. The answers revealed that 20 of the patients were completely free of symptoms or had improved. Three had suffered aggravation of the symptoms. Patient opinion varied widely; 18 were satisfied with the long-term result, and five regretted the procedure. The importance of preoperative information and patient selection before surgery is emphasized.

Adolescent↗
PubMed1999

[Villonodular synovitis--a rare condition causing intermittent locking of the knee].

Two patients with intermittent locking, mimicking a meniscal lesion or a loose body and with a palpable tumour in the knee joint are described. X-ray examinations were normal. Athroscopy revealed pedunculated tumours in both knees. The tumours were removed arthroscopically in one patient and by an arthrotomy in the other patient. The histological diagnosis was localized villonodular synovitis (giant-cell tumour) in both patients. This is a benign but very rare condition.

Adult↗
PubMed1998

[Quality assurance of back surgery. A follow-up of 350 patients treated for sciatica by means of survival analysis].

350 patients underwent a follow-up 2-16 years after back surgery. The aim was to find quality indicators, such as frequency of complications, recurrences and reoperation, in addition to establishing postoperative status and patient satisfaction. The complication rate was 9.7%. Most complications were not serious, and there was no mortality. We found a cumulative recurrency rate of 18% and a cumulative reoperation rate of 12%. Women had significantly better long-term results than men, psychosocial problems being a strong negative predictor. Questionnaires revealed that 76% of the patients were satisfied, whereas 22% were not. Postoperatively, 59% reported a persistent, but usually slight back problem.

Adolescent↗
PubMed1994

Meniscal lesions treated with suture: a follow-up study using survival analysis.

Fifty-seven patients, 45 males and 12 females with a median age of 23 years (range 8-56), underwent meniscal refixation by suture from 1986 through 1991. We used an arthroscopic outside-in technique with PDS sutures through injection cannulas. Thirty-six knees were stable and 21 had anterior cruciate insufficiency, five of which were subjected to surgery concomitantly with patellar tendon reconstruction and two of which were subjected to surgery at a later occasion. Fifty-one patients could be evaluated at a follow-up time of 2 months to 5.5 years (median 1.5, mean 2), and calculations were made using the BMDP statistical package and the Kaplan-Meier survival analysis. No serious complications were encountered. Twenty patients (39%) have undergone reoperation because of meniscal rerupturing. At 5 years, the cumulative survival rate is 50%. Smaller (posterior) lesions healed better than did more extensive lesions. No statistical influence of factors such as medial or lateral localization, age of patient or lesion, present displacement of meniscus, instability of the knee, or experience of the surgeon was evident.

Adolescent↗
PubMed1993

[Follow-up of sutured meniscus by means of survival analysis].

We describe a retrospective study of patients operated by meniscal suture at our hospital from 1986 through 1992. 63 patients were operated, 50 males and 13 females. Mean age was 26 years. Complete data were retrieved at follow-up for 57 patients. Mean observation time was two years. 90% were operated using the arthroscopical technique. 25 patients have been re-operated because of meniscal rerupture. The cumulative survival rate was 44% five years after operation. Survival analysis revealed no significant differences by variables such as sex, age, instability and lateral or medial location revealed. Experienced surgeons achieved only insignificantly better long-term results than did trainees. There was no significant difference in healing rate between displaced bucket-handle and non-displaced tears, nor between chronic and acute tears.

Adolescent↗
PubMed1991

Ischaemic necrosis of lesser curve of stomach after proximal gastric vagotomy.

Of 483 patients treated by proximal gastric vagotomy (PGV) between 1972 and 1986 four (0.8%) developed lesser curve necrosis with perforation and one died of diffuse peritonitis. Gastroscopy 3-6 days after PGV in 26 patients between November 1985 and May 1987 showed that five had developed ischemic ulcers on the lesser curve (19%). One further patient developed lesser curve necrosis with perforation before endoscopy, giving a total of six lesser curve lesions after 26 vagotomies (23%). Endoscopy also showed that most patients had some gastric retention. Ulcers with maximal diameters of 0.4-2 cm were asymptomatic. One patient with a large ischaemic ulcer (3 cm) had an abrupt fall in haemoglobin concentration (from 148 to 73 g/l) as did two patients who developed lesser curve necrosis with perforation and peritonitis (143 to 93, and 159 to 71, respectively). We conclude that ischemic ulcers are relatively common after PGV, that small ulcers are asymptomatic and do not perforate, and that an upper GI bleeding after PGV strongly suggests that lesser curve necrosis has developed.

Aged↗
PubMed1991

Reperitonealization of the lesser curve in proximal gastric vagotomy for duodenal ulcer.

Ninety-six consecutive patients were operated upon with proximal gastric vagotomy for duodenal ulcer at our department during the two year period 1976 to 1978. These patients were prospectively randomized into two groups, one of which (45 patients) had reperitonealization of the lesser curve. These two groups are compared herein. Reperitonealization of the lesser curve was without benefit on long term clinical results, ulcer recurrence rate and gastric acid secretion. None of the patients had perforation of the lesser curve.

Adolescent↗
PubMed1991

Proximal gastric vagotomy for peptic ulcer disease: follow-up of 483 patients for 3 to 14 years.

During the years 1972 to 1986, proximal gastric vagotomy was performed in 483 patients for management of duodenal, pyloric, or prepyloric ulcers. In 25 patients a drainage procedure was added because of pyloric stenosis. The operations were performed by 64 surgeons, most of whom were junior residents. After surgery four patients had lesser curve necrosis; one of the patients died. The 14-year cumulative ulcer recurrence rate was similar (about 13%) in patients treated for duodenal and pyloric/prepyloric ulcers. The cumulative recurrence rate was significantly higher in women (17%) than in men (12%). Twenty-three percent of female patients and 16% of male patients were considered Visick grade 4. Moderate dumping occurred in 29% and diarrhea in 7% of the patients. The diarrhea was moderate except in one patient who had disabling diarrhea. Women had more frequent nausea, epigastric fullness after meals, and food intolerance than men. Basal acid output, pentagastrin-stimulated peak acid output, and insulin-stimulated peak acid output were not found to be reliable tests for evaluating the completeness of vagotomy or predicting ulcer recurrence.

Duodenal Ulcer↗
PubMed1990

[Breast conserving surgery in breast cancer. Experiences from the Haukeland Hospital 1983-88].

From 1983-88, 97 breast cancers in 94 women were treated with breast conserving surgery at Haukeland University Hospital. 71% of the tumours were less than 2 cm in diameter and 94% less than 3 cm. 65% had negative axillary nodal status. 90 patients had ductal carcinoma, three of whom also had extensive intraductal carcinoma. Pathological findings in the resection margins (invasive carcinoma, intraductal carcinoma or atypical epithelial hyperplasia) were reasons for reoperation in 14 patients, eight of them by mastectomy. Thus, after completion of initial treatment the breast was preserved in 89 patients. Postoperative irradiation to the breast was given as a routine. Three elderly patients were excepted. Two patients developed ipsilateral breast recurrences after six and 24 months respectively. The first was treated by re-resection and the second by mastectomy. Neither of these showed evidence of distant metastases. Distant metastases were discovered in five patients, two of these have since died.

Adult↗
PubMed1990

[Breast-preserving surgery in breast cancer. Experiences from Haukeland Hospital 1983-1988].

From 1983-88, 97 breast cancers in 94 women were treated with breast-conserving surgery at Haukeland University Hospital. 71 per cent of the tumours were less than 2 cm in diameter and 94 per cent less than 3 cm. 65 had negative axillary nodal status. 90 patients had ductal carcinoma, three of whom also had extensive intraductal carcinoma. Pathological findings in the resection margins (invasive carcinoma, intraductal carcinoma or atypical epithelial hyperplasia) were reasons for reoperation in 14 patients, eight of them by mastectomy. Thus, after completion of initial treatment the breast was preserved in 89 patients. Postoperative irradiation to the breast was given as a routine. Three elderly patients were excepted. Two patients developed ipsilateral breast recurrences after six and 24 months respectively. The first was treated by re-resection and the second by mastectomy. Neither of these showed evidence of distant metastases. Distant metastases were discovered in five patients, two of these have since died.

Adult↗
PubMed1988

Treatment of stomach cancer, a national experience.

A total of 1165 patients with stomach cancer were entered into a prospective, observational national study. They represented 54 per cent of all stomach cancer patients reported to the Cancer Registry in Norway during the study period, and data are analysed for three hospital levels (local, county and university hospitals). The median age was 71 years (range 18-96 years). The median pretreatment delay was 113 days, and 46 per cent of patients had a performance status (Karnofsky index) of less than or equal to 80. The diagnosis was confirmed by pre-operative histology in 88 per cent of cases. In all, 88 per cent of patients underwent surgery, the resectability rate was 67 per cent and 50 per cent had a potential curative operation. Total gastrectomy was most commonly performed. Lymph node dissection was performed in 14 per cent of those undergoing a curative resection. The postoperative complication rate was 27 per cent but varied with the type of operation, being highest in proximal resection (55 per cent) and lowest after distal resection (19 per cent). A total of 7 per cent of the patients died postoperatively. Most patients had advanced disease at the time of treatment and only 6 per cent had stage I tumours. There were significant differences in patient and treatment characteristics between the three hospital levels. In conclusion, patient selection bias which will influence results does occur. A fairly aggressive attitude towards local disease was found, but the low proportion of patients undergoing lymph node dissection not only leads to questions regarding the efficacy of this treatment policy, but also casts doubt on the validity of staging of stomach cancer. Morbidity and mortality rates are still high. The consequences of the differences revealed between hospital groups are difficult to interpret. Proponents of both regionalization of treatment and small hospital care may find arguments for their case in the data.

Adult↗