Structured and Systematic Team and Procedure Training in Severe Trauma: Going from 'Zero to Hero' for a Time-Critical, Low-Volume Emergency Procedure Over Three Time Periods.

Background: Resuscitative emergency thoracotomy is a potential life-saving procedure but is rarely performed outside of busy trauma centers. Yet the intervention cannot be deferred nor centralized for critically injured patients presenting in extremis. Low-volume experience may be mitigated by structured training.

Performance and outcome evaluation of emergency resuscitative thoracotomy in a Norwegian trauma centre: a population-based consecutive series with survival benefits.

Background: Emergency resuscitative thoracotomy (ERT) is a lifesaving procedure for select indications in severely injured patients. The main body of the literature stem from regions with a high prevalence of penetrating injuries, while data from European institutions remain scarce. We aimed to evaluate a decade of ERT in a Norwegian trauma centre.

Long-Term Outcomes After Open Repair for Ruptured Abdominal Aortic Aneurysm.

Background: Early mortality in ruptured abdominal aneurysm (rAAA) is high, but data on long-term outcome are scarce. The aim of this study was to investigate the long-term outcome in survivors after open surgery for rAAA in well-defined population.

Methods: This is a population-based, observational long-term follow-up (beyond 30-day mortality) study of patients surgically treated for rAAA from 2000 through 2014.

Phlegmasia cerulea dolens secondary to an aortoiliac aneurysm.

Phlegmasia cerulea dolens is an uncommon entity. We present a case of phlegmasia cerulea dolens secondary to an aortoiliac aneurysm that compressed the common iliac vein. Catheter-directed thrombolysis was not considered to be a suitable option, because the patient needed an urgent fasciotomy.

A Population-Based Study of Incidence, Presentation, Management and Outcome of Primary Thromboembolic Ischemia in the Upper Extremity.

Objectives: To investigate the epidemiology of acute upper limb thromboembolism in a well-defined Norwegian population.

Methods: This study was a retrospective, single-center, observational population-based cohort study of acute upper limb thromboembolism. The study included all patients from the hospital's primary catchment area from January 2000 to December 2015.

Characteristics, Stratification and Time to Death in a Population-Based Cohort of Patients with Ruptured Abdominal Aortic Aneurysms Not Undergoing Surgery.

Background: The available literature on ruptured abdominal aortic aneurysms (rAAA) centers on survival after operation and commonly, reasons why some patients do not undergo surgery are not addressed. The aim of the present study is to examine, in a population-based cohort, the characteristics, stratification and time to death of patients admitted to hospital, but not undergoing operation for rAAA.

Methods: A retrospective, single-center study.

Editor's Choice - The National Norwegian Carotid Study: Time from Symptom Onset to Surgery is too Long, Resulting in Additional Neurological Events.

Objective/background: The objective was to observe for 1 year all patients in Norway operated on for symptomatic carotid stenosis with respect to (i) the time from the index event to surgery and neurological events during this time; (ii) the level in the healthcare system causing delay of surgical treatment; and (iii) the possible relationship between peri-operative use of platelet inhibitors and neurological events while awaiting surgery.

Methods: This was a prospective national multicentre study of a consecutive series of symptomatic patients. Patients were eligible for inclusion when referred for surgery.

Comparing the accuracy of four prognostic scoring systems in patients operated on for ruptured abdominal aortic aneurysms.

Objective: Ruptured abdominal aortic aneurysms (rAAAs) are associated with high mortality and morbidity. Several prognostic scoring systems are available for prediction of outcome, but scarcity of external validation and evaluation of predictive value has hampered widespread implementation. The aim of this study was to examine the discriminatory value of four scores in a consecutive Norwegian cohort.

Epidemiology of ruptured abdominal aortic aneurysms in a well-defined Norwegian population with trends in incidence, intervention rate, and mortality.

Objective: Ruptured infrarenal abdominal aortic aneurysms (rAAAs) represent both a life-threatening emergency for the affected patient and a considerable health burden globally. The aim of this study was to investigate the contemporary epidemiology of rAAA in a defined Norwegian population for which both hospital and autopsy data were available.

Methods: This was a retrospective, single-center population-based study of rAAA.

Efficacy of a two-tiered trauma team activation protocol in a Norwegian trauma centre.

Background: A registry-based analysis revealed imprecise informal one-tiered trauma team activation (TTA) in a primary trauma centre. A two-tiered TTA protocol was introduced and analysed to examine its impact on triage precision and resource utilization.

Methods: Interhospital transfers and patients admitted by non-healthcare personnel were excluded.

A randomized controlled study of uncomplicated gallstone disease with a 14-year follow-up showed that operation was the preferred treatment.

Background/aims: Cholecystectomy is considered the treatment of choice for symptomatic gallstone disease. Some patients abstain from surgery and provide the opportunity to study the natural history of cholelithiasis. The aim of the present study was to examine the feasibility and safety of observation after extended long-term follow-up in a randomized controlled trial.

Long-term follow-up of a randomized controlled trial of observation versus surgery for acute cholecystitis: non-operative management is an option in some patients.

Background: Cholecystectomy is routinely recommended to prevent recurrent disease after an initial episode of acute cholecystitis. Therefore, randomized controlled trials have mainly focused on the timing of surgery, but many patients scheduled for cholecystectomy have deferred surgery with long periods of symptom-free intervals. Our present aim is to examine the long-term feasibility and safety of observation compared with surgery.

[Abdominal aortic aneurysms--endovascular and open surgery].

Background: In Norway, repair of abdominal aortic aneurysms is performed in more than 800 patients annually. Open repair is an established procedure, but an increasing number of patients have undergone endovascular repair during the last decades. The paper delivers an up to date discussion of infrarenal abdominal aortic aneurysm repair.

The result of liver resection for colorectal metastases in a small volume hospital in western Norway.

Aim: Our aim was to compare liver resection for colorectal metastases in a non-referral, small volume unit with a dedicated staff, with results from larger units.

Methods: Thirty patients (15 men and 15 women) with a median age of 64years (range 29-78) underwent hepatic resection during a 5-year period from 1997 to 2003 in a teaching hospital in western Norway.

Results: Sixty-three percent (19/30) of the colorectal tumours were Dukes stage C (n=19) and CEA was increased in seven patients (23%), of which four (13%) had values above 50microg/l.

Association between gallstone-evoked pain, inflammation and proliferation of nerves in the gallbladder: a possible explanation for clinical differences.

Objective: To investigate whether enhanced neuroproliferation could be involved in the pathogenesis of gallstone pain.

Material And Methods: Gallbladders from 117 patients with gallstones and 43 controls were examined. The gallbladder samples were immunostained against the pan-neuronal marker PGP 9.

Resuscitative emergency thoracotomy in a Scandinavian trauma hospital--is it justified?

Objective: Resuscitative emergency thoracotomy (ET) is of value in selected (penetrating) trauma patients. Current survival-estimates and recommended guidelines are based on data from the United States. However, reports from European trauma centres are lacking.

Pain attacks in non-complicated and complicated gallstone disease have a characteristic pattern and are accompanied by dyspepsia in most patients: the results of a prospective study.

Objective: The cardinal indication for surgical treatment of gallstones is pain attacks. However, following cholecystectomy, 20% of patients remain symptomatic. It is unclear to what extent post-cholecystectomy symptoms can be ascribed to persistence of preoperative symptoms or to new pathology.

Endovascular repair of abdominal aortic aneurysms with aortocaval fistula.

Objectives: To examine the risk of high-flow type II endoleak following endovascular repair of abdominal aortic aneurysm with aortocaval fistula.

Design: Case reports.

Subjects: Two patients with abdominal aortic aneurysms with aortocaval fistula.