Prehospital computed tomography in a rural district for rapid diagnosis and treatment of stroke.

Background: Early diagnosis and triage of patients with ischemic stroke is essential for rapid reperfusion therapy. The prehospital delay may be substantial and patients from rural districts often arrive at their local hospital too late for disability-preventing thrombolytic therapy due to prolonged transport times.

Methods: Hallingdal District Medical Centre (HDMC) is located in a rural area of Norway and is equipped with a computed tomography (CT) scanner.

Robotic Pauli repair of parastomal hernia.

Background: Robotic retro-muscular mesh repair of parastomal hernia (PH) is possible with transversus abdominis release. The aim of this study is to report mid-term results with this method.

Methods: Patients who underwent surgery for PH were enrolled in a prospective study.

3-dimensional computer tomography is more accurate than traditional long-leg radiographs in the planning and evaluation of coronal alignment in total knee arthroplasty: a prospective study on 121 knees.

Background And Purpose: Accurate measuring tools are essential in preoperative planning and for the study of the association between postoperative alignment and clinical outcome in total knee arthroplasty (TKA). We aimed to describe a simple method to measure preoperative hip-knee-femoral shaft (HKFS) angle and postoperative coronal alignment in TKA with the use of standard 3D CT and to compare preoperative HKFS angles and postoperative coronal alignment measured with the 3D CT technique and with standing long-leg hip-knee-ankle (HKA) radiographs.

Patients And Methods: HKA radiographs and 3D CT were taken preoperatively and 3 months after the operation in 121 knees.

Robotic hernia surgery IV. English version : Robotic parastomal hernia repair. Video report and preliminary results.

The surgical treatment of parastomal hernias is considered complex and is known to be prone to complications. Traditionally, this condition was treated using relocation techniques or local suture repairs. Since then, several mesh-based techniques have been proposed and are nowadays used in minimally invasive surgery.

[Robotic hernia surgery IV. German version : Robotic parastomal hernia repair. Video report and preliminary results].

The surgical treatment of parastomal hernias is considered complex and is known to be prone to complications. Traditionally, this condition was treated using relocation techniques or local suture repairs. Since then, several mesh-based techniques have been proposed and are nowadays used in minimally invasive surgery.

A human relevant mixture of persistent organic pollutants induces reactive oxygen species formation in isolated human leucocytes: Involvement of the β2-adrenergic receptor.

Exposure to chlorinated (Cl), brominated (Br) and perfluoroalkyl acid (PFAA) persistent organic pollutants (POPs) is associated with immunotoxicity and other adverse effects in humans and animals. Previous studies on POPs have mainly focused on single chemicals, while studies on complex mixtures are limited. Using DCF and luminol assays we examined effects on ROS generation in isolated human neutrophils, monocytes and lymphocytes, after in vitro exposure to a total mixture and sub-mixtures of 29 persistent compounds (Cl, Br, and PFAA).

The Dugdale planning method for high tibial osteotomies underestimates the correction angle compared to the Miniaci method.

Purpose: The purpose of this study was to compare the planning methods of Dugdale and Miniaci for high tibial osteotomies (HTO) and to assess how their use could influence on the degree of correction and thus the postoperative weight bearing line (WBL).

Methods: Pre- and postoperative standing hip-knee-ankle (HKA) radiographs were obtained from 70 patients that underwent HTO. The correction angles were determined using Dugdale's and Miniaci's methods, and for the latter, both for an opening wedge as well for a closing wedge osteotomy.

Bias in animal studies of estrogen effects on cardiovascular disease: A systematic review and meta-analysis.

Background: Randomized controlled trials on menopausal hormone therapy in humans have not confirmed the benefit of estrogens on cardiovascular disease found in animal studies. Flawed methodology or publication bias in animal studies may explain the dicrepancy.

Objectives: The aim of this study was to investigate whether publication of the randomized controlled trials Heart and Estrogen/Progestin Replacement Study and Women's Health Initiative influenced study authors' assessment of research findings (confirmation bias) as well as to investigate publication bias and small-study effects in animal studies of estrogen effects on atherosclerosis.

Endoscopic preperitoneal parastomal hernia repair (ePauli repair) : an observational study.

Background: Aspiring endoscopic surgery with extraperitoneal mesh application to avoid adhesion and pain from mesh fixation, we adopted the principles of the open Pauli repair of parastomal hernia (PSH). We have termed the procedure ePauli repair. The aim of this account is to inform about feasibility and adverse reactions.

Mini-invasive Surgery and Parastomal Hernia: Higher Frequency and No Prophylactic Mesh Effect.

Aim: Parastomal hernia (PSH) is very common. Recent reports suggest increased frequency after laparoscopic stoma formation compared with open surgery. A retrospective chart review was designed to appraise the outcomes regarding PSH in open and in laparoscopic procedures.

No detrimental effect of ligament balancing on functional outcome after total knee arthroplasty: a prospective cohort study on 129 mechanically aligned knees with 3 years' follow-up.

Background and purpose - In the classical mechanical alignment technique, ligament balancing is considered a prerequisite for good function and endurance in total knee arthroplasty (TKA). However, it has been argued that ligament balancing may have a negative effect on knee function, and some authors advocate anatomic or kinematic alignment in order to reduce the extent of ligament releases. The effect of the trauma induced by ligament balancing on functional outcome is unknown; therefore, the aim of this study was to investigate this effect.

Do clinicians want recommendations? A multicenter study comparing evidence summaries with and without GRADE recommendations.

Objectives: Evidence-based clinical practice guidelines provide recommendations to assist clinicians in decision-making and to reduce the gap between best current research evidence and clinical practice. However, some argue that providing preappraised evidence summaries alone, rather than recommendations, is more appropriate. The objective of the study is to evaluate clinicians' preferences, and understanding of the evidence and intended course of action in response to evidence summaries with and without recommendations.

Reduced survival for uncemented compared to cemented total hip arthroplasty after operatively treated acetabular fractures.

Background: Post traumatic arthritis and avascular necrosis of the femoral head are common complications after operatively treated acetabular fractures. This may cause severe disabilities for the patient, necessitating a total hip arthroplasty. Even though an arthroplasty may provide good symptomatic relief, the long-term results are more uncertain and no consensus exists according to preferred prosthetic designs.

A simple method for accurate rotational positioning of the femoral component in total knee arthroplasty.

Background and purpose - There are many techniques for placing the femoral component in correct rotational alignment in total knee arthroplasty (TKA), but only a few have been tested against the supposed gold standard, rotation determined by postoperative computed tomography (CT). We evaluated the accuracy and variability of a new method, the clinical rotational axis (CRA) method, and assessed the association between the CRA and knee function. Patients and methods - The CRA is a line derived from clinical judgement of information from the surgical transepicondylar axis, the anteroposterior axis, and the posterior condylar line.

Multilayered and digitally structured presentation formats of trustworthy recommendations: a combined survey and randomised trial.

Objectives: To investigate practicing physicians' preferences, perceived usefulness and understanding of a new multilayered guideline presentation format-compared to a standard format-as well as conceptual understanding of trustworthy guideline concepts.

Design: Participants attended a standardised lecture in which they were presented with a clinical scenario and randomised to view a guideline recommendation in a multilayered format or standard format after which they answered multiple-choice questions using clickers. Both groups were also presented and asked about guideline concepts.

The role of contrast-enhanced ultrasound in the classification of CT-indeterminate renal lesions.

Objective: Focal renal lesions are common incidental findings on computed tomography (CT). For lesions with a cystic appearance, the Bosniak classification system has enabled an important separation of benign and (potentially) malignant cysts, giving a practical guide for management. The purpose of this study was to evaluate contrast-enhanced ultrasound (CEUS) as a problem-solving modality for classification of indeterminate renal lesions detected with CT.

Compression Stockings for Preventing the Postthrombotic Syndrome in Patients with Deep Vein Thrombosis.

Objective: We conducted a systematic review and meta-analysis to address benefits and harms of using elastic compression stockings after lower-extremity deep vein thrombosis.

Methods: We searched 7 electronic databases through January 15, 2015, including randomized controlled trials (RCTs)/quasi-randomized trials reporting on elastic compression stocking efficacy on postthrombotic syndrome incidence, recurrent venous thromboembolism, mortality, and acute pain after deep vein thrombosis. Two reviewers independently screened records, extracted data, assessed risk of bias, and assessed confidence in effect estimates using Grading of Recommendations Assessment, Development, and Evaluation methodology.

Prophylactic mesh at end-colostomy construction reduces parastomal hernia rate: a randomized trial.

Aim: Parastomal hernia (PSH) is the most common complication of an end-colostomy and about one-quarter of patients need operative repair, which is often unsuccessful. A randomized trial was carried out to compare the results of using mesh or no mesh at the time of formation of a colostomy with the clinical identification of PSH as the primary outcome.

Method: In this two-centre randomized trial (Oslo University Hospital and Sykehuset Innlandet Hospital Trust, Norway), patients with rectal cancer undergoing open pelvic surgery were randomized to receive a retromuscular synthetic mesh (study group, n = 32) or no mesh (control group, n = 26) at the time of end-colostomy formation.

Biochemical lung, liver and kidney markers and early death among elderly following hip fracture.

Introduction: In the elderly, hip fracture is a common injury associated with high early mortality dominated by cardiorespiratory and thromboembolic events. Identification of risk factors that can be modified by treatment has caught attention over the last years. This study was conducted to assess biological markers on perioperative organ dysfunction and its association with early mortality within 3 months after surgery.

Awareness of heredity in colorectal cancer patients is insufficient among clinicians: a Norwegian population-based study.

Objective: The assessment of family history and medical data is crucial in identifying families with Lynch syndrome (LS). Among consecutive colorectal cancer (CRC) patients, we aimed at identifying all patients with a hereditary predisposition, and to study a possible discrepancy with assessments made by the responsible clinicians.

Method: All consecutively diagnosed patients with CRC from two Norwegian hospitals were included, and information on family history was collected in a detailed interview.

Pre-induction cervical ripening with 25 microg and 50 microg vaginal misoprostol in 181 nulliparous parturients.

Objective: To evaluate the effect of intravaginally misoprostol at start dosages of 25 microg and 50 microg when used for pre-induction cervical ripening among nulliparous parturients.

Methods: Our observational study involves all cases of partus induction consecutively registered in a Norwegian hospital between September 2002 and August 2006, with the following inclusion criteria: nulliparous, singleton pregnancies >or=37 weeks, an unfavourable cervix (Bishop score 2499 g, received misoprostol vaginally every 6 h upto four times. Seventy-six women started with 25 microg (25 microg-group) and 105 started with 50 microg (50 microg-group).

Bishop score and the outcome of labor induction with misoprostol.

Background: The aim of the study was to retrospectively identify possible factors for predicting the outcome of induction with misoprostol.

Methods: Fifty micrograms of misoprostol were administered intravaginally every 6 h during the first 2 days of induction, up to a maximum of 4 doses. The Bishop score, indication for induction, gestational length, maternal age, and parity were analyzed.