Geir Egil Eide

Aim: To identify clinical, anatomical, and technical predictors associated with successful extracorporeal shock wave lithotripsy (ESWL) outcomes in patients with nephrolithiasis undergoing nurse‐led ESWL treatment. Design: Prospective descriptive observational study. Methods: A total of 461 ESWL treatments for nephrolithiasis performed between November 2016 and June 2024 at St. Olav's University Hospital, a tertiary university hospital in Trondheim, were analysed. A consecutive sampling strategy was used to minimize selection bias. Data on stone characteristics (size, density, and anatomical location) and treatment‐related parameters were extracted from patient records. These variables were selected based on recommendations from the European Association of Urology. Logistic regression was used to identify predictors of treatment success (defined as stone‐free or residual fragments ≤ 4 mm). Results: Three variables were associated with treatment success: stone laterality, size and density. Right‐sided stones were more likely to be successfully treated (OR 1.77, p = 0.004), while larger and denser stones were less likely to achieve complete clearance (OR 0.91, p = 0.003 and OR 0.99, p = 0.012 respectively). The overall success rate was comparable to outcomes reported for urologist‐led procedures. Conclusion: ESWL performed by trained nurses seems to be safe and effective. Findings support an expanded nursing role in advanced urological procedures and provide knowledge that can improve patient selection and resource utilization. Implications for the Profession and/or Patient Care: Nurse‐led ESWL appears to achieve success rates comparable to physician‐led models when delivered by appropriately trained nurses. Impact: This study adds evidence for task shifting in specialized healthcare settings and demonstrates that nurses can deliver high‐quality treatment. The findings have implications for competence development, patient access, and efficient use of urological resources. Reporting Method: STROBE. Patient or Public Contribution Reporting Method: No Patient or Public Contribution.

Background/Objectives: Psychological distress, including symptoms of anxiety and depression, is common among individuals with inflammatory bowel disease (IBD) and may adversely affect well-being and disease management. However, routine assessment of mental health is not consistently integrated into clinical care. This study assessed the prevalence of anxiety and depression among patients newly diagnosed with IBD at diagnosis and after three months of treatment and explored associations between psychological symptoms, disease activity, and clinical characteristics. Methods: This prospective cohort study included 304 adults newly diagnosed with IBD and treated at Stavanger University Hospital between 2012 and 2019. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale at baseline and after three months. Disease activity was evaluated using the Harvey–Bradshaw Index and Partial Mayo Score. Clinical variables included C-reactive protein, faecal calprotectin, folate, cobalamin, and body mass index. Multivariable regression analyses were conducted to identify factors associated with psychological symptoms. Results: The prevalence of anxiety decreased from 29.8% at diagnosis to 21.6% after three months, while the prevalence of combined anxiety and depression declined from 22.2% to 16.3%. The prevalence of depression alone remained stable over time. Higher disease activity, particularly as measured by the Harvey–Bradshaw Index, showed the strongest association with anxiety and depressive symptoms. However, after adjustment for potential confounders, no significant improvement in psychological symptoms was observed, suggesting that the association between time and HADS scores may be explained by changes in one or more measured covariates. Conclusions: Psychological symptoms remained common during the first months following an IBD diagnosis and were closely associated with disease activity. Medical treatment alone was insufficient to achieve meaningful improvements in mental health outcomes. These findings highlight the importance of systematic psychological assessment, early identification of emotional distress, and integrated multidisciplinary care, including nursing-led screening and supportive interventions, for individuals newly diagnosed with IBD.

Iron deficiency is common in patients with inflammatory bowel disease (IBD) and may lead to a variety of distressing symptoms negatively impacting quality of life. This prospective observational cohort study aimed to assess quality of life, measured using the Short Form-36 (SF-36) questionnaire before and after treatment with high-dose intravenous iron in patients with IBD and iron deficiency. Over a 15-month period, 130 patients with a well-established diagnosis of IBD (either ulcerative colitis (UC) or Crohns disease (CD)) and confirmed iron deficiency were consecutively assessed for study eligibility at two university hospitals in South-Eastern Norway. Of these, 112 patients were included in the per protocol set. Demographic characteristics were recorded at study inclusion. Clinical, and biochemical variables, as well as SF-36 questionnaires were collected just before and 5-7 weeks after treatment with intravenous iron. An improvement was observed in six of the eight SF-36 domains six weeks after treatment with intravenous iron. Females had lower scores compared to males at both visits, but there were no differences between UC and CD patients. Both sexes and the two diagnoses had a significant increase in vitality scores. Haemoglobin level was a significant predictor for improvement of quality of life. Treatment with high dose intravenous iron improves quality of life in IBD patients and iron deficiency and particularly in those with anaemia. The most significant improvements were observed in vitality and energy levels, suggesting a clinically meaningful change.

Background/Objectives: Peripheral intravenous catheters are commonly employed to administer intravenous therapy to hospitalized patients. However, their use can result in complications, with phlebitis occurring in approximately 11% of cases and bloodstream infections in about 0.18%. This study aimed to enhance PIVC management in a local hospital by implementing a comprehensive care bundle to mitigate these complications. Methods: This quality improvement study involved the collection of data from 1330 PIVCs in adult patients, both prior to and following the implementation of the intervention. Data collection occurred between June 2022 and November 2023, employing the validated Peripheral Intravenous Catheter-Mini Questionnaire (PIVC-miniQ). This instrument comprises 16 observation points that assess phlebitis-related signs and symptoms, the integrity of PIVC dressings and IV connections, and the adequacy of documentation. Results: The prevalence of phlebitis decreased from 15.1% at baseline to 9.4% post-intervention (p = 0.018). Significant predictors of phlebitis included the intervention, ward, gender, and PIVC gauge. Improvements were also noted in PIVC dressing and IV connection practices, as well as documentation standards (p < 0.001). Closed integrated PIVCs outperformed ported PIVCs in the PIVC-miniQ scores after the intervention (p < 0.001). A statistically significant difference was observed in the mean PIVC-miniQ sum score post-intervention compared to baseline (p < 0.001). Conclusions: This study indicates that implementing a care bundle can enhance the quality of PIVCs and reduce the prevalence of phlebitis. Further high-quality research is needed to identify the most effective care bundles for preventing PIVC-related complications.

1) Background: Several studies have shown the benefit of drawing when learning anatomy. Virtual Reality (VR) also appears to be useful to increase the understanding of the location of anatomical structures. This study aims to describe how students in an Operating Room Nursing (OR nursing) master study program perceive the benefit of active learning methods, including drawing and the use of VR. 2) Methods: We combined these two methods in a class of 29 students. 38 half-finished drawings of anatomical structures were made. The students were to complete these during lectures with guidance from the teacher. The students also attended a two-hour VR session where they were to find various anatomical structures. A paper questionnaire was applied to evaluate the teaching program. Data were analyzed statistically. 3) Results: The students highly appreciated these learning methods. They reported that drawing made them work more actively during lectures and increased their learning outcome. They also perceived that the use of VR technology increased their understanding of the location of anatomical structures. 4) Conclusion: The combination of drawing and VR technology may be of benefit to OR Nursing students when learning anatomy by both increasing student activity and learning outcomes.

Aims: Patients with symptomatic aortic valve stenosis are efficiently treated by aortic valve replacement (AVR), using a biological or mechanical valve. For some patients with mechanical valves, the metallic clicking sound may be problematic. The aim of this study was to investigate the perceived disturbance from the sound of a mechanical valve and the association between noise perception and symptoms of anxiety and depression. Methods and results: The study had a cross-sectional design. In April 2013, all patients who had undergone AVR at one university hospital during the period 2000–12 were invited by post to participate. The primary variables were assessed using a valve-specific questionnaire and the Hospital Anxiety and Depression Scale. Of the 912 (77%) respondents, 245 had mechanical valves. Of these, 59 (24%) were women, the mean (standard deviation) age was 61 (11) years, and the mean time since surgery was 7 (3) years. The valve-specific questionnaire showed that 84% of the patients could sometimes or often hear the valve sound. A moderate positive correlation was found between valve prosthesis noise disturbance and anxiety, r = 0.35 (P = 0.001), and depression, r = 0.27 (P = 0.001). In a multiple linear regression analysis, valve noise perception was only significantly associated with anxiety among several other bio-psychosocial factors. Conclusion: This study shows an association between valve noise disturbance and symptoms of anxiety and highlights the importance of preparing all patients for the sound from the mechanical valves that arises after surgery.

A major challenge in the follow-up of patients treated with stereotactic radiosurgery (SRS) for brain metastases (BM) is to distinguish pseudoprogression (PP) from tumor recurrence (TR). The aim of the study was to develop a clinical risk assessment score. Follow-up images of 87 of 97 consecutive patients treated with SRS for 348 BM were analyzed. Of these, 100 (28.7%) BM in 48 (53.9%) patients responded with either TR (n = 53, 15%) or PP (n = 47, 14%). Differences between the 2 groups were analyzed and used to develop a risk assessment score (the Bergen Criteria). Factors associated with a higher incidence of PP vs. TR were as follows: prior radiation with whole brain radiotherapy or SRS (P = .001), target cover ratio ≥98% (P = .048), BM volume ≤2 cm³ (P = .054), and primary lung cancer vs. other cancer types (P = .084). Based on the presence (0) or absence (1) of these 5 characteristics, the Bergen Criteria was established. A total score 3 points were associated with 84% TR and 16% PP, P < .001. Based on 5 characteristics at the time of SRS the Bergen Criteria could robustly differentiate between PP vs. TR following SRS. The score is user-friendly and provides a useful tool to guide the decision making whether to retreat or observe at appropriate follow-up intervals.

Context: Testicular growth represents the best clinical variable to evaluate male puberty, but current pediatric hormone references are based on chronological age and subjective assessments of discrete puberty development stages. Determination of testicular volume (TV) by ultrasound provides a novel approach to assess puberty progression and stratify hormone reference intervals. Objective: The objective of this article is to establish references for serum testosterone and key hormones of the male pituitary-gonadal signaling pathway in relation to TV determined by ultrasound. Design, Setting, and Participants: Blood samples from 414 healthy Norwegian boys between ages 6 and 16 years were included from the cross-sectional “Bergen Growth Study 2.” Participants underwent testicular ultrasound and clinical assessments, and serum samples were analyzed by liquid chromatography tandem–mass spectrometry and immunoassays. Main Outcome Measures: We present references for circulating levels of total testosterone, luteinizing hormone, follicle-stimulating hormone, and sex hormone–binding globulin in relation to TV, chronological age, and Tanner pubic hair stages. Results: In pubertal boys, TV accounted for more variance in serum testosterone levels than chronological age (Spearman r = 0.753, P < .001 vs r = 0.692, P < .001, respectively). Continuous centile references demonstrate the association between TV and hormone levels during puberty. Hormone reference intervals were stratified by TV during the pubertal transition. Conclusions: Objective ultrasound assessments of TV and stratification of hormone references increase the diagnostic value of traditional references based on chronological age or subjective staging of male puberty.

Clinical assessment of pubertal breast development using Tanner staging is subjective. This has led to the introduction of ultrasound (US), aiming for a more objective analysis. However, information regarding its reliability is lacking.