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Truls E Bjerklund Johansen

Publications and source records attributed to Truls E Bjerklund Johansen.

15 recordsLinked to original sources
PubMed2006

Prevalence of hospital-acquired urinary tract infections in urology departments.

OBJECTIVES: The aim of our study was to register the prevalence of nosocomial urinary tract infections (NAUTIs) in urology sections in Europe and Asia. METHODS: A total of 6033 hospitalised patients in 194 different urology departments were screened in two Internet-based studies. Detailed reports on 727 patients with NAUTI were provided. RESULTS: The prevalence of NAUTI was 10% in the Pan European Prevalence (PEP) study, 14% in the Pan EuroAsian Prevalence (PEAP) study, and 11% in the combined analysis. The largest group was asymptomatic bacteriuria (29%) followed by cystitis (26%), pyelonephritis (21%), and urosepsis (12%). There were significant differences between regions and types of hospitals. CONCLUSIONS: NAUTI is a large problem for urologic patients and causes huge extra costs for hospitals.

Adolescent↗
PubMed2006

Hospital acquired urinary tract infections in urology departments: pathogens, susceptibility and use of antibiotics. Data from the PEP and PEAP-studies.

Data from two internet-based studies on NAUTI in hospitalized urological patients are presented together: the Pan European Prevalence (PEP) study, which was a 1-day prevalence study in November 2003; and the Pan Euro-Asian Prevalence (PEAP) study, which was carried out in November 2004. Overall, 93 and 101 hospitals from the two studies, respectively, completed the hospital questionnaires and provided patient information for the present study. NAUTI was diagnosed according to the Centres for Disease Control and Prevention (CDC) criteria in 727 of the 6033 patients hospitalized on study days in urological departments. The most commonly reported pathogen was Escherichia coli (31%), followed by species of Pseudomonas (13%), Enterococcus (10%), Klebsiella (10%), Enterobacter (6%) and Proteus (6%). Candida spp. and Pseudomonas spp. occurred significantly more frequently as causative agents in urosepsis than in other types of infections. The resistance of E. coli, Klebsiella and Proteus spp. was below 45% for the most commonly used antibiotics. Enterococcus spp. and Pseudomonas spp. however, had resistance rates above 70% to most antibiotics. A total of 56% of the hospitalized urological patients were receiving antimicrobial therapy on the study day; 46% for prophylaxis, 26% for microbiologically proven UTI, 21% for only clinically suspected UTI and 7% for other infections. The most commonly used antibiotics were fluoroquinolones (35%), cephalosporins (27%), penicillins (16%), aminoglycosides (15%), and co-trimoxazole (9%). Differences between countries and regions were highly significant. There is an urgent need for continuous surveillance of NAUTI and improvement of antibiotic policy to counteract the widespread increase of antimicrobial resistance.

Anti-Bacterial Agents↗
PubMed2005

[Radical therapy for prostate cancer in Norway].

There is an increasing incidence of localised prostate cancer in Norway. Treatment decisions should be based on published results for treatment modalities. This paper presents an overview of Norwegian results published between 1982 and 2003. The treatment modalities used were: transurethral resection of the prostate followed by laser coagulation, radical prostatectomy, external beam radiation, cryotherapy, and brachytherapy. There were no controlled studies and no evidence that the treatment offers health benefit to the patients. The observation periods were generally very short. Frequency of complications is significant. Radical surgery is followed by 8-77% urinary incontinence, 38-96% loss of erection, and 25% other complications. External beam radiation gives 20% lower urinary tract symptoms, 51% loss of erection and 13-86% intestinal complications. For cryotherapy there is no incontinence, 74% erectile failures and 10-43% other complications.

Brachytherapy↗
PubMed2005

[Cryotherapy for prostate cancer].

BACKGROUND: The paper describes the principles and technique of cryotherapy for prostate cancer. MATERIAL AND METHODS: From September 2003 to January 2005 we have treated 40 patients with localised prostate cancer. Among patients with T1-2 tumours, Gleason score < 7 and PSA < 10 ng/ml, average prostate-specific antigen (PSA) after 3 months is 0.32 (< 0.05-1.2) ng/ml. Among patients with T1-2, Gleason score > or = 7 or PSA > or = 10, average PSA after 3 months is 0.56 (< 0.05-1.9) ng/ml. RESULTS AND DISCUSSION: Two patients needed intermittent catheterisation for a short period and underwent revision of the prostatic cavity. After 3 months, however, all patients had normal micturition. The prostate was not palpable in any of the patients. Our experience is encouraging and comparable to what has recently been reported from other countries.

Aged↗
PubMed2005

EAU guidelines for the management of genitourinary tuberculosis.

Nearly one third of the world's population is estimated to be infected with Mycobacterium tuberculosis. Moreover, tuberculosis is the most common opportunistic infection in AIDS patients. Genitourinary tuberculosis is not very common but it is considered as a severe form of extra-pulmonary tuberculosis The diagnosis of genitourinary tuberculosis is made based on culture studies by isolation of the causative organism; however, biopsy material on conventional solid media may occasionally be required. Drug treatment is the first line therapy in genitourinary tuberculosis. Treatment regimens of 6 months are effective in most of the patients. Although chemotherapy is the mainstay of treatment, surgery in the form of ablation or reconstruction may be unavoidable. Both radical and reconstructive surgery should be carried out in the first 2 months of intensive chemotherapy.

Antitubercular Agents↗
PubMed2004

The role of imaging in urinary tract infections.

The aim of imaging in urinary tract infections (UTI) is to detect conditions that must be corrected to avoid imminent deterioration of kidney function, or to prevent recurrent infections and long-term kidney damage. The most threatening conditions are obstruction of an infected upper tract and abscesses of the genitourinary system. An image-guided percutaneous drainage can be lifesaving. The role of imaging in small children with UTI is controversial in terms of the importance of anatomical and functional disorders in relation to the preventive measures to be taken. In newborns identified with hydronephrosis during pregnancy or by neonatal screening, vesicoureteral reflux (VUR) and renal scarring are congenital and not caused by infection. Most of these patients are males and the VUR is of a higher grade than VUR detected in girls after the first UTI. Imaging in children with UTI should only be ordered after a thorough evaluation of the risk of renal damage and the benefits of preventive measures. In adult females, no imaging is necessary in cystitis, while ultrasonography and plain films are recommended in acute pyelonephritis. Since uncomplicated UTI in men is rare, diagnostic imaging should be started early to rule out complicating factors in the urinary tract. In prostatitis, vesiculitis, epididymitis and orchitis the role of imaging is to rule out abscess formation and testicular malignancies.

Diagnostic Imaging↗
PubMed2004

Nosocomially acquired urinary tract infections in urology departments. Why an international prevalence study is needed in urology.

Nosocomially acquired urinary tract infection (NAUTI) is the most frequent nosocomial infection and a particular problem in urology departments. The incidence of NAUTI has become an important quality parameter and a legal issue. Several characteristics related to the health care provider, the patient and the procedures are known to increase the risk of NAUTI. The single most important risk factor for NAUTI is an indwelling catheter. NAUTI may be prevented by good health care facilities, evidence-based practice, wise patient selection and surgical skill. But the most important factors are tailored antibiotic prophylaxis and continuous monitoring of the incidence and pathogens causing NAUTI in each institution. Raising antimicrobial resistance in some countries calls for a closer monitoring of NAUTI on international level within urology. There is room for improvement in urinary catheter care in many hospitals, and the importance of patient and urological risk factors for development of NAUTI is not fully known. In order to meet these challenges the European Society for Infections in Urology is planning a prevalence study combined with a quality improvement initiative related to NAUTI.

Antibiotic Prophylaxis↗
PubMed2003

Brachytherapy for prostate cancer: a systematic review of clinical and cost effectiveness.

OBJECTIVES: Brachytherapy is emerging as a new treatment option for prostate cancer, and is increasingly being used in Europe and North America. METHODS: A systematic review of studies that compared clinical or cost effectiveness of prostate brachytherapy with radical prostatectomy or external beam radiation for patients with localised prostate cancer. RESULTS: No randomised controlled trials were identified, but five observational studies with comparable patient groups were included in the review. There were no valid data on overall or disease-free survival. There was no difference in disease-free survival based on PSA as a surrogate measure, or in rates of complications. No cost effectiveness studies were found. Based on Norwegian data, the one-year cost of the three treatment options seem fairly similar, while long term cost data are lacking due to lack of data on long term clinical outcome. CONCLUSION: The evidence on the clinical effectiveness of therapies for localised prostate cancer is scarce, but the outcome appears to be comparable for radical prostatectomy, external beam radiotherapy and brachytherapy.

Aged↗
PubMed2002

Diagnosis and imaging in urinary tract infections.

The aim of imaging in urinary tract infection is to detect conditions that must be treated in order to avoid immediate deterioration or recurrences, and probable long-term kidney damage. In newborns identified with hydronephrosis during pregnancy or by neonatal screening, vesicoureteral reflux and renal scarring are congenital and not caused by infection. Most of these patients are male and the vesicoureteral reflux is of a higher grade than that detected in girls having had urinary tract infection. In children with urinary tract infection, several authors advocate a more selective policy and recommend imaging only in those children who are at risk for developing renal damage. In adult females no imaging is necessary in cystitis, whereas ultrasonography and plain films are recommended in acute pyelonephritis. Because uncomplicated urinary tract infection in men is rare, diagnostic evaluation including imaging should be started early in order to rule out complicating factors within the urinary tract. The role of imaging in prostatitis, vesiculitis, epididymitis and orchitis is primarily to rule out abscess formation, but also to exclude testicular malignancies.

Adult↗
PubMed2002

Understanding chronic pelvic pain syndrome.

Patients with non-inflammatory chronic pelvic pain syndrome, the largest group of prostatitis patients according to the US National Institute of Diabetes and Digestive and Kidney Diseases classification, are characterized by the absence of objective findings. Nothing thus links the symptoms of this disease to the prostate or other male organs in particular. For this reason, observations on interstitial cystitis in women are of interest to understand the chronic pelvic pain syndrome. New information from studies on the inflammatory response in expressed prostatic secretion in patients with chronic pelvic pain syndrome and in bladder tissue from patients with interstitial cystitis indicates that complex systems on the cytokine gene expression level may be operating in these diseases. Research findings point to a common denominator at the level of molecular biology that might explain how the symptoms of chronic pelvic pain syndrome and interstitial cystitis can be precipitated by pathogens, inflammatory reactions and even neurological mechanisms. The initial clinical trial reports of drugs that modulate the inflammatory response in interstitial cystitis are met with great interest.

Arylsulfonates↗