Stavanger University Hospital

Published data describing epidemiological trends of abdominal injury on a national level are scarce. This study aims to analyse trends in demographics, severity, population-adjusted incidences, and short-term outcomes of abdominal trauma based on national trauma register data. Observational, complete national cohort study of all consecutive traumatic incidents resulting in abdominal injuries reported to the National Trauma Register (NTR) of Norway between 2015 and 2023. The NTR has demonstrated an overall coverage rate of 92.2% of trauma patients, with excellent data accuracy. Standardised incidence rates were estimated using the direct method with standard populations. Temporal trends were evaluated in regression models. Abdominal injuries occurred in 9.0% (7086/78,416) of all registered traumatic incidents. Children represented 18.1% (n = 1275) of the patients, and 14.8% (n = 1047) were elderly. The median age was 35 years (interquartile range, IQR: 19-55) and increased by 0.4 years annually (95% confidence interval, CI: 0.0-0.8). Men accounted for 69.5% (n = 4926) and 30.5% (n = 2160) were female. Blunt injury type dominated with 85.3% (n = 6044). Traffic-related accidents were the most common mechanism (48.0%, n = 3401), followed by falls (26.9%, n = 1903). The median Injury Severity Score (ISS) was 10 (IQR 2-18), and 36.3% (n = 2567) displayed ISS>15 indicating severe injury. Polytrauma occurred in 20.6% (n = 1457) of trauma cases suffering abdominal injury. Age- and sex-adjusted incidence of all abdominal injuries was 14.9/100,000/year (95% CI: 14.5-15.3). The annual increase was 0.43 per 100,000 person-years (95% CI: 0.14-0.71) among children and 0.68 per 100,000 person-years (95% CI: 0.39-0.97) for elderly patients. The subgroup of solid organ injuries showed an adjusted incidence of 7.2/100,000/year (95% CI: 7.0-7.5), and hollow viscus injuries of 1.2/100,000/year (95% CI: 1.1-1.3). Overall 30-day mortality was 3.4% (n = 240), with no statistically significant change during the study period. Trauma patients presenting with abdominal injury are getting older. One third sustained severe injuries and one in five patients suffered polytraumatic injuries. The incidence of abdominal trauma increased over the last decade, predominantly amongst elderly patients and children. The mortality was low, and stable over time. None.

Schizophrenia patho-etiology may involve endothelial inflammation and blood-brain barrier (BBB) dysregulation with cellular adhesion molecules (CAMs) as important mediators. CAMs are essential for cellular integrity but can show increased levels in inflammation. Cognitive dysfunction precedes and exists independently of psychotic symptoms in schizophrenia patients. CAMs could impact cognition through influence on BBB integrity. To gain insights into disease mechanisms and potential therapeutic targets, we explored the relationship between CAMs protein levels and neurocognitive tests in schizophrenia-spectrum disorders in the BeSt InTro study. Seventy-one in- and out-patients underwent CAMs measurements and neuropsychological testing on a minimum of one time point: baseline, 6, 26, or 52weeks. Cognitive domains included working memory, processing speed, verbal abilities, executive functions, and overall cognition. CAMs analyzed were neural CAMs: junctional adhesion molecule (JAM-A) and neural cadherin (N-CAD); vascular CAMs: intercellular adhesion molecule (ICAM)-1, vascular adhesion molecule (VCAM)-1, mucosal addressin cell adhesion molecule (MADCAM), and platelet (P)-selectin from fasting blood samples. Linear mixed effects models, adjusted for age, sex, body mass index, smoking, education, and drug naivety, estimated CAMs effect on cognitive outcome measures. N-CAD levels correlated positively with overall cognition (p=0.002), working memory (p=0.034), and executive functions (p=0.0011). ICAM-1 levels correlated positively with overall cognition (p=0.037). Conversely, JAM-A levels correlated negatively with executive functions (p=0.021). Associations between CAMs (N-CAD, ICAM-1, JAM-A) and neurocognitive tests suggest CAMs may impact cognition in schizophrenia. Contrary to our hypothesis, most associations between CAMs levels and cognitive tests were positive. Future research on mechanisms is mandatory.

We aimed to assess the association between body mass index and polyunsaturated fatty acids to determine potential links and metabolic differences between Alzheimer's disease and dementia with Lewy bodies. We performed a cross-sectional study of enrolment data with 133 patients with mild AD (n = 75) and DLB (n = 58) from a Norwegian cohort study. We used linear regression models adjusting for age, sex, and diagnosis to explore the association between PUFA concentrations and BMI estimates. In DLB patients, BMI was positively associated with downstream omega-6 PUFA, including gamma-linolenic acid (GLA; β = 0.285, p = 0.012), arachidonic acid (AA; β = 0.320, p = 0.005), and adrenic acid (β = 0.303, p = 0.005). BMI was also related to increased Δ6-desaturase n-6 activity (β = 0.383, p = 0.002) and Δ6-desaturase n-3 activity (β = 0.335, p = 0.011), along with reduced elongase n-6 (β = -0.396, p = 0.002) and elongase n-3 (β = -0.376, p = 0.004), suggesting increased fatty acid turnover. No significant associations were found in the AD group. BMI in DLB patients was positively associated with elevated downstream omega-6 metabolites and desaturase and elongase activity, compatible with higher fatty‑acid turnover and systemic inflammatory state hypothesized in DLB. These findings highlight the distinct metabolic alterations across dementia subtypes that are relevant for personalized nutritional strategies in dementia care.

To estimate the six-month prevalence of dementia with Lewy bodies (DLB) in a Colombian memory clinic using the Lewy Body Composite Risk Score (LBCRS) and interdisciplinary consensus diagnosis, and to describe the scale's clinical performance parameters. We analyzed data from 850 patients evaluated over six months at the Intellectus Memory Clinic in Bogotá, Colombia (HUSI). The LBCRS was applied in addition to a standardized interdisciplinary assessment that included clinical, paraclinical, and neuropsychological evaluations. Final diagnoses were established by consensus based on current international criteria for DLB. LBCRS data were available for 592 participants (69.6%). Of these, 42 (7.1%) screened positive (score ≥3), but only 5 (0.84%) received a consensus diagnosis of probable DLB. Six screened-positive patients were diagnosed with Parkinson's disease dementia (PDD); in three, cognitive symptoms developed within one year of motor onset and could alternatively be classified as DLB, increasing the number of DLB cases to 8. The remaining LBCRS-positive patients were diagnosed with Alzheimer's disease, vascular dementia, mild cognitive impairment, or no cognitive disorder. LBCRS performance in this setting demonstrated a sensitivity of 100%, specificity of 94.2%, positive predictive value of 19%, and negative predictive value of 100%. The low incidence of DLB identified by interdisciplinary assessment, together with the discrepancy between LBCRS screening and final diagnoses, underscores the need for further research on the applicability and predictive value of LBCRS in Latin America.

Impaired clinical insight is common in schizophrenia spectrum disorders (SSDs) and predicts poor treatment adherence and outcomes. It is linked to disorganised, positive, negative, and hostility symptoms. However, few studies repeatedly assess insight after antipsychotic initiation while comparing pharmacologically distinct agents. This study examined how symptom levels and changes predict the development and endpoint of clinical insight over 6 weeks, contrasting the partial dopamine agonist aripiprazole (PDA) with two dopamine antagonists (DAs). Data from 144 SSD patients in the Bergen-Stavanger-Innsbruck-Trondheim (BeSt InTro) trial, a pragmatic, semi-randomised study of amisulpride, aripiprazole, and olanzapine, were analysed using latent growth curve models. Insight was measured by PANSS Item G12; symptom factors (positive, negative, hostility, cognitive/disorganised) were derived from PANSS. Lower baseline symptoms and greater improvement between weeks 3 and 6 predicted better insight at 6 weeks across all factors. For positive symptoms, improvement between weeks 1 and 3 (b = 0.57, p = 0.009) also predicted better insight. Patients on aripiprazole showed less improvement in insight, though some findings lost significance after correction. Symptom reduction is associated with improved insight, with early changes in positive symptoms exerting the fastest effect. Despite symptom improvement, aripiprazole PDA treatment was linked to less insight gain than DA treatment. These preliminary findings warrant further study.

Cardiac organ damage (OD) is associated with increased risk of cardiovascular disease. However, limited knowledge exists on cardiac OD in young patients with cryptogenic ischaemic stroke (CIS). To explore prevalence and covariates of cardiac OD in patients with CIS compared to controls participating in the SECRETO study. We analysed data from 427 patients with CIS aged <50 years and 361 age- and sex-matched controls. OD was defined as presence of abnormal left ventricular (LV) geometry (LV hypertrophy or concentric remodelling) or left atrial enlargement (LAE) assessed by echocardiography, using sex-specific threshold values. Compared to controls, patients had higher prevalences of obesity and tobacco smoking, patent foramen ovale (PFO) (52% vs. 25%) and abnormal LV geometry (12% vs. 7%, all p < 0.01), while presence of LAE did not differ. In multivariable analyses, CIS was associated with presence of abnormal LV geometry (odds ratio 1.86 [95% confidence interval 1.09-3.20], p=0.024). In separate multivariable analyses in patients only, obesity was associated with both abnormal LV geometry and LAE (both p < 0.01), and higher systolic blood pressure only with presence of abnormal LV geometry (p < 0.001). No significant association with PFO was found. In young patients with CIS participating in the SECRETO study, abnormal LV geometry was more prevalent compared to age- and sex-matched controls and associated with presence of higher blood pressure and obesity. The results point to the importance of blood pressure and weight control in CIS to prevent progression of cardiac OD and recurrent cardiovascular events.

Dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) share overlapping cognitive and neuropsychiatric symptoms, complicating early differential diagnosis. This study aimed to compare multidimensional impairment patterns in AD and DLB and develop a simple, interpretable classification model based on clinical scales. A total of 249 participants were included: 84 patients with AD, 82 with DLB, and 83 participants with normal cognition (NC). Participants completed assessments covering global cognition, six cognitive domains, neuropsychiatric and depressive symptoms. Missing values in cognitive scales were handled using multiple imputation, and results were pooled across all imputations. Then, Least Absolute Shrinkage and Selection Operator (LASSO), Support Vector Machine (SVM), and Random Forest (RF) were used to identify key variables. A final set of six scales was selected to build a logistic regression model distinguishing DLB from AD. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) in the entire cohort, mild stage and dementia stage. DLB patients showed greater deficits in attention, visuospatial processing, and neuropsychiatric symptoms; AD patients exhibited more pronounced memory impairment. At mild stage, DLB displayed more depressive symptoms and attention deficits but milder memory decline than AD. At dementia stage, DLB presented broader impairments in executive, visuospatial, attentional, with similar global cognition. The six-feature model achieved high diagnostic accuracy in the entire cohort (AUC=0.879, 95%CI: 0.802-0.957), mild stage (AUC=0.866, 95% CI: 0.788-0.943) and dementia stage (AUC=0.939, 95% CI: 0.839-0.999). The study identified distinct cognitive profiles of DLB and AD, and developed a concise, clinically practical model with robust diagnostic utility across disease stages, supporting its use in outpatient and resource-limited settings.

Brain network architecture is anticipated to influence future grey matter loss in individuals at Clinical High Risk (CHR) for psychosis. However, existing studies on grey matter structural network properties in CHR are scarce and constrained by small sample sizes. Here, we examined network topology differences comparing a) CHR versus healthy controls (HC); b) CHR who transitioned to psychosis (CHR-T) versus those who did not (CHR-NT); and c) different subsyndromes. We included structural scans from 1842 CHR individuals and 1417 HC individuals from 31 sites within the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) consortium. At the global level, CHR individuals exhibited lower structural covariance (q < 0.001; Cohen's d = 0.164) and less optimal structural network configuration than HC (lower global efficiency and clustering coefficient, d = 0.100,0.087, qs <= 0.027). Though no global difference between CHR-T and CHR-NT, network distinctiveness of the frontal and temporal surface area networks was higher in CHR-T than CHR-NT (d = 0.223,0.237) and HC (d = 0.208,0.219) (qs < 0.001). Network distinctiveness of the frontal cortical thickness network was lower in CHR-T (d = 0.218, q < 0.001) than CHR-NT and HC (d = 0.165, q < 0.001). Importantly, higher network distinctiveness was associated with worse positive symptoms in CHR-NT (frontal surface area, q = 0.008, R2 = 0.013) and at trend with worse negative symptoms in CHR-T (frontal thickness, q = 0.063, R2 = 0.049). Further, the brief intermittent psychotic syndrome subgroup showed more severe network alterations. Together, brain structural networks inform symptoms and the risk of transition to psychosis in CHR individuals.