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Biomedical subjects

Geir Aamodt

Publications and source records attributed to Geir Aamodt.

17 recordsLinked to original sources
PubMed2006

Relation between concentration of air pollution and cause-specific mortality: four-year exposures to nitrogen dioxide and particulate matter pollutants in 470 neighborhoods in Oslo, Norway.

This study investigated the concentration-response relation between air pollution (nitrogen dioxide and particulate matter pollutants PM(10) and PM(2.5)) and cause-specific mortality. The population included all inhabitants of Oslo, Norway, aged 51-90 years on January 1, 1992 (n = 143,842) with follow-up of deaths from 1992 to 1998. An air dispersion model (AirQUIS; Norwegian Institute for Air Research (NILU), Oslo, Norway) was used to estimate levels of exposure in 1992-1995 in all 470 administrative neighborhoods. These data were linked to census, education, and death registries. A consistent effect on all causes of death was found for both sexes and age groups by all indicators of air pollution. The effects appeared to increase at nitrogen dioxide levels higher than 40 micro g/m(3) in the youngest age group and with a linear effect in the interval 20-60 micro g/m(3) for the oldest. An effect of all indicators on cardiovascular causes, lung cancer, and chronic obstructive pulmonary disease was also found in both age groups and sexes. The effects were particularly strong for chronic obstructive pulmonary disease, which appeared to have linear effects, whereas cardiovascular causes and lung cancer seemed to have threshold effects. Results show that vulnerable persons with chronic obstructive pulmonary disease and the elderly seem to be susceptible to air pollution at lower levels than the general population.

Aged↗
PubMed2006

Dimensionality and scalability of the Motor Assessment Scale (MAS).

PURPOSE: The Motor Assessment Scale (MAS) has shown to be a reliable and valid instrument for measuring motor functioning for stroke patients. The purpose of this paper was to study dimensionality and scalability of the instrument. METHOD: A total number of 137 patients were evaluated at admission and on discharge. To study dimensionality and scalability, Partial Credit Models (PCM) were applied for the eight items in the instrument and also for the upper limb and lower limb activities separately. Studies were performed to compare subgroups such as young/old, men/women and diagnosis to examine if the items had the same meaning for the subgroups. RESULTS: The items showed the same ordering for admission and discharge. Infit and outfit values varied between 0.5 and 1.9 at admission and 0.5 and 1.7 on discharge. CONCLUSIONS: We conclude that the scalability of the different items is not optimal. For some items, the top and/or bottom levels are overrepresented and for other items the middle levels tend to cluster. There seems to be a single construct except for one of the items. The instrument also showed the same meaning for the different subgroups.

Adult↗
PubMed2006

A simulation study of three methods for detecting disease clusters.

BACKGROUND: Cluster detection is an important part of spatial epidemiology because it can help identifying environmental factors associated with disease and thus guide investigation of the aetiology of diseases. In this article we study three methods suitable for detecting local spatial clusters: (1) a spatial scan statistic (SaTScan), (2) generalized additive models (GAM) and (3) Bayesian disease mapping (BYM). We conducted a simulation study to compare the methods. Seven geographic clusters with different shapes were initially chosen as high-risk areas. Different scenarios for the magnitude of the relative risk of these areas as compared to the normal risk areas were considered. For each scenario the performance of the methods were assessed in terms of the sensitivity, specificity, and percentage correctly classified for each cluster. RESULTS: The performance depends on the relative risk, but all methods are in general suitable for identifying clusters with a relative risk larger than 1.5. However, it is difficult to detect clusters with lower relative risks. The GAM approach had the highest sensitivity, but relatively low specificity leading to an overestimation of the cluster area. Both the BYM and the SaTScan methods work well. Clusters with irregular shapes are more difficult to detect than more circular clusters. CONCLUSION: Based on our simulations we conclude that the methods differ in their ability to detect spatial clusters. Different aspects should be considered for appropriate choice of method such as size and shape of the assumed spatial clusters and the relative importance of sensitivity and specificity. In general, the BYM method seems preferable for local cluster detection with relatively high relative risks whereas the SaTScan method appears preferable for lower relative risks. The GAM method needs to be tuned (using cross-validation) to get satisfactory results.

Bayes Theorem↗
PubMed2006

[A midwife-led birthing unit].

BACKGROUND: The Alternative Birth Centre (ABC) is a midwife-led unit which offers low-risk women integrated, individualised antenatal, intrapartum and postpartum care. MATERIAL AND METHODS: The study included 432 women who received their care at the ABC from November 1997 until July 2000. Demographic information and details about antenatal care were recorded for all women. Information about labour, delivery and the postnatal period were recorded for the 341 women who started their labour at the ABC. RESULTS: Of the 432 women who started their care at the ABC, 265 (61.3 %) gave birth there, 100 (38 %) were primiparous while 165 (62.3 %) were multiparous. 84 (19.4 %) women were not suitable for birth at the ABC for reasons such as preterm birth, postterm pregnancies, breech presentation and preeclampsia, and were referred back to their own hospital during pregnancy. Among the 341 women that started labour at the ABC, 76 (22 %) were transferred to the obstetrical department during labour. Three reasons accounted for 88 % off all transfers during labour: failure to progress (n = 34, 44.7 %), need for continuous fetal monitoring (n = 20, 26.3 %), and the need for pharmacological pain relief (n = 13, 17.1 %). Of the 76 women transferred in labour, 42 had a spontaneous vaginal birth while 36 (44.7 %) women had an operative delivery, 14 caesarean section, 16 vacuum extraction and 1 of them forceps delivery. One baby born at the ABC had an Apgar score below 7 at 5 min. ABC is a safe alternative to standard care for low-risk women.

Adult↗
PubMed2006

Gross Motor Function Classification System used in adults with cerebral palsy: agreement of self-reported versus professional rating.

The present study investigated the reliability of self-reported rating of Gross Motor Function Classification System (GMFCS) levels compared with professional rating, and changes in gross motor function over time, in adults with cerebral palsy. Twenty-nine females and 33 males aged between 18 years 5 months and 62 years 11 months (mean age 34y 7mo [SD 10y 6mo]) participated in the study. Participants rated their current gross motor function using the GMFCS and reported their judgement of their gross motor function at age 10 to 12 years. The project leader, a physical therapist, also classified participants' current GMFCS levels and conducted a chart review on all accessible medical records of participants' gross motor function when they were 10 to 12 years old, rating the GMFCS level accordingly. Intraclass correlation coefficients (ICC) between self-reported and professional ratings showed excellent agreement (ICC=0.93-0.95, 95% confidence interval [CI] 0.89-0.97). More than half the participants experienced a stable gross motor function from the age of 10 to 12 years to the present. Those at GMFCS Levels II and III at the age of 10 to 12 years (according to the professional rating) had significant change for the worse in gross motor function over time, with odds ratios of 9.30 (95% CI 1.2-73.0, p=0.03) and 7.00 (95% CI 1.1-43.0, p=0.04) respectively. Interview data on circumstances regarding changes in gross motor function since childhood are also reported. Changes in GMFCS level were mostly associated with physical or social environmental factors.

Adolescent↗
PubMed2005

[Presentation of statistical analysis in the Journal of the Norwegian Medical Association].

The present paper describes guidelines for the presentation of statistical analysis in manuscripts submitted to the Journal of the Norwegian Medical Association, in order to ensure a reasonable standard of statistic presentation in the journal. The paper is a supplement to the guidelines for authors in the journal and should not be used as replacement for statistics manuals.

Guidelines as Topic↗
PubMed2005

Meconium induced IL-8 production and intratracheal albumin alleviated lung injury in newborn pigs.

We have recently shown that albumin added to meconium before intratracheal instillation in newborn pigs limits detrimental effect on the lungs and reduces increase of IL-8. The aim of this study was to test the effect of albumin instillation as rescue treatment in meconium aspiration syndrome (MAS). MAS was induced in hypoxic piglets by lung instillation of meconium (MAS I = 675 mg/kg, n=12; MAS II=540 mg/kg, n=14). Morbidity and mortality differed (MAS I, dead=7/12; MAS II, dead=5/14). MAS groups were randomized to postmeconium instillation of either bovine albumin (30%, 1.4 mL/kg; MAS I, n=6; MAS II, n=7) or isotonic saline (9 mg/mL, 1.4 mL/kg; MAS I, n=6; MAS II, n=7). The controls (n=4) were tested by sequential instillation of saline (9 mg/mL, 5 mL/kg) and albumin (30%, 1.4 mL/kg). Lung function and gas exchange deteriorated significantly after instillation of meconium [oxygenation index (OI): MAS I, +814%; MAS II, +386%; ventilation index (VI): MAS I, +256%; MAS II, +162%; compliance: MAS I, -53%; MAS II, -44%]. Increases of tracheal IL-8 correlated to deterioration of lung function were 10- (MAS I) and 5-fold (MAS II) (p <0.001). Lung compliance was higher in albumin instillation versus saline instillation (MAS I, p=0.008; MAS II, p=0.002). Albumin did not influence intergroup differences in IL-8, hemodynamics, OI, or VI. MAS-induced IL-8 increases correlated with deterioration of lung function (OI, VI, and compliance). Rescue treatment with albumin in meconium aspiration improved lung compliance in piglets and may represent a new therapeutic approach to MAS.

Albumins↗
PubMed2005

Assessment of early mother-child relation in infants with oesophageal atresia.

Fifteen one-year old infants with oesophageal atresia and their parents were used to demonstrate how the Parent-Child Early Relational Assessment (PCERA) can be used to explore the mother-child interaction in a clinical sample of children. The infants and their mothers were videotaped for 5-min episodes during feeding and free play, and the quality of the mother-infant interactions was assessed by PCERA. The results showed areas of strength regarding most of the maternal, infant and dyadic components. There was concern about maternal positive physical contact, maternal quality of verbalizations to or about the child, maternal social initiative, infant's communicative competence and infant's visual contact with mother. This concern of social proximity between infants and their mothers was most prominent in the feeding situation. The present study indicates that oesophageal atresia in infants may constitute stressors impinging on the parent-infant relationship. PCERA was found to be an adequate assessment tool with acceptable reliability to evaluate the mother-infant interaction.

Adult↗
PubMed2005

Survival after surgery for congenital heart defects: does reduced early mortality predict improved long-term survival?

AIM: The objectives of this study were 1) to compare early mortality (first 30 d after surgery) and long-term survival between two cohorts of patients operated on for congenital cardiac defects, and 2) to evaluate the impact of possible changes in early mortality on long-term survival. METHODS: 945 patients with congenital cardiac defects, born in 1990-1999 and operated on in the same period were examined in a retrospective cohort study. The patients were divided into three groups: "univentricular cardiac defects", "severe cardiac defects" and "less severe cardiac defects". The study population was divided into two cohorts: group 1 included patients born and operated on in 1990-1994; group 2 included patients born and operated on in 1995-1999. The survival patterns in the two groups were compared. RESULTS: For all patients, except those with univentricular cardiac defects, early mortality (30 d after surgery) was reduced. Among patients with severe cardiac defects, early mortality was reduced from 18.6% in group 1 to 2.9% in group 2. Among patients with less severe cardiac defects, early mortality was reduced from 6.2% to 1.9%. The improved outcome was maintained during the following 5 y. Overall relative risk of death during follow-up was reduced to 0.31 (95% CI: 0.15-0.56) for patients with severe cardiac defects, and to 0.53 (95% CI: 0.31-0.93) for patients with less severe cardiac defects born and operated on in 1995-1999. CONCLUSION: Early mortality has been substantially reduced in congenital heart defect patients, and corresponds with significantly improved long-term survival.

Child, Preschool↗
PubMed2004

Complement activation reflects severity of meconium aspiration syndrome in newborn pigs.

Meconium aspiration syndrome (MAS) is a serious condition in newborns, associated with a poorly characterized inflammatory reaction. The aim of this study was to investigate a possible role for complement in pulmonary pathophysiology and systemic inflammation in experimental MAS. MAS was induced by instillation of meconium into the lungs of 12 hypoxic piglets. Six controls received saline under otherwise identical conditions. Hemo- and lung dynamics were recorded for 5 h. Plasma complement activation, revealed by the terminal sC5b-9 complex (TCC), and cytokines were measured by enzyme immunoassays. TCC increased substantially in MAS animals compared with controls (p <0.0005). The increase in TCC correlated with lung dysfunction: closely with oxygenation index (r=0.51, p <0.0001) and ventilation index (r=0.64, p < 0.0001) and inversely with lung compliance (r=-0.22, p=0.05). IL-1beta and tumor necrosis factor-alpha increased significantly in MAS animals compared with the controls (p=0.004 and 0.008, respectively). The cytokine increase occurred later than TCC and showed correlations with lung dysfunction similar to TCC. IL-10 did not discriminate between MAS animals and controls (p=0.32). Finally, the subgroup of MAS animals that died (n=5) had substantially higher TCC concentration compared with the surviving MAS animals (n=7; p <0.0005). TCC increased substantially in MAS and was closely correlated to lung dysfunction. Complement activation preceded cytokine release, which may suggest a primary role for complement in the pathophysiology of MAS.

Animals↗
PubMed2004

[Paracetamol to preschool children--indications and cultural background].

BACKGROUND: Immigrants may have a different attitude to the use of paracetamol (acetaminophen) than parents of western European or North American origin. The aim of this study was to examine under what conditions parents find treatment with paracetamol appropriate. MATERIAL AND METHOD: Parents at six public health centres were asked to select one or more among 26 indications for paracetamol treatment and to state the body temperature at which fever medication should be used. The indications were independently evaluated as appropriate, uncertain or inappropriate by the staff of the public health centres. RESULTS: 1563 (99%) parents participated in the study. 79% chose a fever threshold of 39 degrees C or above as appropriate for treatment with paracetamol. Fever, earache, influenza and headache were frequently chosen as appropriate indications by both parents and staff. On average, parents from non-western countries more frequently chose indications considered by the staff as uncertain or inappropriate and seemed to use paracetamol more frequently (odds ratio 2.35; 95% CI 1.26-4.40) and in larger doses than other parents did. INTERPRETATION: This study indicates that parents from non-western countries use paracetamol for their children on wider indications, to more of their children, and in larger doses than other parents do.

Acetaminophen↗
PubMed2004

[The use of paracetamol and antibiotics among preschool children].

BACKGROUND: Sales of paracetamol in paediatric formulations are increasing and antibiotics are frequently prescribed to children. Our aim was to study the use of paracetamol and antibiotics in different age groups among preschool children. MATERIAL AND METHODS: Parents of 1312 children (99% response rate) visiting public health centres were asked to state how often their child had been sick, used paracetamol, seen a doctor, or used antibiotics during the previous three months. If the child had used antibiotics, parents were asked to give the reason for treatment, the name of the drug used, and the duration of treatment. RESULTS: 71% of the children had been sick, 46% had received paracetamol, 36% had seen a doctor, and 12% had used antibiotics. The highest frequency of illness and paracetamol use was seen among children one to two years of age. Otitis was the main reason for using antibiotics in children of one to four years of age, and the duration of treatment was often longer than recommended. INTERPRETATION: Use of paracetamol is widespread among preschool children. Parents going back to work after maternity leave and more frequent fever resulting from exposure to infections may contribute to an increased use of paracetamol. Restrictive use of antibiotics for otitis and shorter treatment duration continue to be emphasised.

Acetaminophen↗
PubMed2004

A population-based study of extra-cardiac anomalies in children with congenital cardiac malformations.

We describe the prevalence of extra-cardiac anomalies in children with congenital cardiac malformations, and their impact on survival, compared to the outcome in children with the congenital cardiac lesions as the only recognised anomaly. Our population comprises the 3527 children born with congenital cardiac anomalies between 1990 and 1999, and registered at the largest tertiary centre for Paediatric Cardiology in Norway. Extra-cardiac anomalies were found in one-fifth of the population, with Down's syndrome accounting for nearly one-third. Survival improved for children born between 1995 and 1999 compared with those born in the period from 1990 to 1994 for all groups, except for children with additional extra-cardiac anomalies in the absence of Down's syndrome. The results were the same for children undergoing surgical treatment of their cardiac malformation. The survival in children with Down's syndrome improved in comparable fashion to those without extra-cardiac anomalies. Children with extra-cardiac anomalies in the absence of Down's syndrome represent a heterogeneous group, with varying patterns of survival. Survival did not improve in these latter patients during the period of our study.

Abnormalities, Multiple↗
PubMed2004

Musculoskeletal pain in adults with cerebral palsy compared with the general population.

OBJECTIVE: To examine prevalence and localization of musculo-skeletal pain in adults with cerebral palsy compared with the general population and to investigate variables potentially associated with pain. DESIGN: A postal survey. SUBJECTS: Persons with cerebral palsy and no intellectual disabilities, 18 years or more, living in Norway. METHODS: A multidimensional questionnaire, including items on musculo-skeletal pain, was sent to 766 adults with cerebral palsy. RESULTS: In total 406 persons responded, 49% females and 51% males age range 18-72 years (mean 34 years). All categories of cerebral palsy were represented. Nearly one-third of the adults with cerebral palsy had chronic pain, vs 15% in the general population. Mean scores of domain of bodily pain on Short Form 36 were significantly lower from an earlier age in adults with cerebral palsy. Back pain was the most common in both groups. Pain in adults with cerebral palsy was significantly associated with gender, chronic fatigue, low life satisfaction and deteriorating physical function. CONCLUSION: Musculo-skeletal pain is a pronounced problem in adults with cerebral palsy from an early age, and should be addressed specifically in the follow-up programs, and in further clinical studies on potential causal pathways.

Adolescent↗
PubMed2003

Nuclear localization of the metastasis-related protein S100A4 correlates with tumour stage in colorectal cancer.

A large number of experimental studies have linked the S100A4 gene product to the metastatic phenotype of cancer cells and clinical evidence indicates a correlation between S100A4 expression and poor prognosis in several cancer types. The aim of the present study was to analyse the expression of the S100A4 protein in colorectal cancer. Paraffin-embedded samples from 277 colorectal cancer patients were immunostained with anti-S100A4 antibody. Cytoplasmic staining was observed in 178 of 277 samples (64%), whereas, unexpectedly, nuclear expression of S100A4 was found in 88 of 277 of the samples (32%). This novel finding was confirmed by western blot analysis of nuclear fractions isolated from frozen tumour tissue. Statistical analysis revealed a significant correlation between nuclear expression of S100A4 and tumour stage at diagnosis, while there was no such correlation between cytoplasmic staining and tumour stage. The nuclear localization of S100A4 in colorectal cancer and its relationship to tumour stage suggest that this protein may be involved in gene regulatory pathways of relevance to the metastatic phenotype of cancer cells.

Adenocarcinoma↗
PubMed2002

Long-term outcome after resection of benign cerebellar astrocytomas in children and young adults (0-19 years): report of 110 consecutive cases.

UNLABELLED: The objective of this retrospective study was to present long-term follow-up data for 110 consecutive children and young adults treated for a benign cerebellar astrocytoma at our institution between 1960 and 2001. Mean age at presentation was 8.9 years. The total surgical mortality was 9%, but declined from 16% in 1960-1977 to 0% in 1988-2001. At the close of the study 97/110 patients were still alive. Nine deaths were surgery related, 2 patients died of shunt-related causes and 2 patients died due to tumor recurrence. Five-, 10- and 25-year survival were 90, 89 and 85%, respectively. Multiple Cox regression analysis showed that tumor infiltration of the brain stem and the time period of surgery were the only explanatory variables significantly associated with survival. Five-year survival improved from 79% in the time period of 1960-1977 to 100% in the time period of 1988-2001. Tumor recurrence after total tumor resection was observed in 5 of 76 (7%) evaluable patients. Growth of residual tumor after subtotal tumor resection was observed in 7 of 26 (27%) evaluable patients. Recent followup MR revealed regression of residual tumor in 14 of 16 patients. Only 5 of these patients had received radiotherapy. Thus, spontaneous regression of residual tumor is a more frequent event than growth of residual tumor. The functional outcome was favorable in 82% of the patients [Karnofsky performance index (KPI) > or = 90]. Eighteen percent of the patients had moderate to severe disabilities (KPI 50-80). CONCLUSIONS: Benign cerebellar astrocytoma is a surgical disease where the prognosis with respect to both survival and functional outcome is favorable. Spontaneous regression of residual tumor is frequently encountered, allowing for observation of residual tumors instead of performing a second resection in cases where a second resection carries a high risk of neurological sequelae.

Adolescent↗