Raphael Adobor | University of Oslo (original) (raw)
Papers by Raphael Adobor
Background: School screening for adolescent idiopathic scoliosis (AIS) is discussed. The aim of t... more Background: School screening for adolescent idiopathic scoliosis (AIS) is discussed. The aim of the present study was to describe the point prevalence of AIS and to evaluate the effectiveness of school screening in 12-yearold children. Methods: Community nurses and physical therapists in the Southern Health region of Norway including about 12000 school children aged 12 years were invited to participate. All participating community nurses and physical therapists fulfilled an educational course to improve their knowledge about AIS and learn the screening procedure including the Adam Forward Bending Test and measurement of gibbus using a scoliometer. Results: Sub-regions including 4000 school children participated. The prevalence of idiopathic scoliosis defined as a positive Adam Forward Bending Test, gibbus > 7° and primary major curve on radiographs > 10°, was 0.55%. Five children (0.13%) had a major curve > 20°. Bracing was not indicated in any child; all children were post...
School screening and point prevalence of adolescent idiopathic scoliosis in 4000 Norwegian childr... more School screening and point prevalence of adolescent idiopathic scoliosis in 4000 Norwegian children aged 12 years
Spine Deformity, 2021
PURPOSE While the Scoliosis Research Society (SRS) has established criteria for brace initiation ... more PURPOSE While the Scoliosis Research Society (SRS) has established criteria for brace initiation in adolescent idiopathic scoliosis (AIS), there are no recommendations concerning other management issues. As the BrAIST study reinforced the utility of bracing, the SRS Non-Operative Management Committee decided to evaluate the consensus or discord in AIS brace management. METHODS 1200 SRS members were sent an online survey in 2017, which included 21 items concerning demographics, bracing indications, management, and monitoring. Free-text responses were analyzed and collated into common themes. Data were analyzed using Microsoft Excel 2013. RESULTS Of 218 respondents; 207 regularly evaluate and manage patients with AIS, and 205 currently prescribe bracing. 99% of respondents use bracing for AIS and the majority (89%) use the published SRS criteria, or a modified version, to initiate bracing. 85% do not use brace monitoring and 66% use both %-Cobb correction and fit criteria to evaluate brace adequacy. In contrast, other aspects of brace management demonstrated a high degree of practice variability. This was seen with a radiographic assessment of maturity level, hours prescribed, timing and frequency of radiographic evaluation, the use of nighttime bracing only, and the method and timing of brace discontinuation. CONCLUSION Although there is consensus in brace management amongst SRS members with respect to brace initiation and evaluation of adequacy, there is striking variability in how bracing for AIS is used. This variability may impact the overall efficacy of brace treatment and may be decreased with more robust guidelines from the SRS. LEVEL OF EVIDENCE III.
Tidsskrift for Den norske legeforening, 2016
Tidsskrift for Den norske legeforening
Full list of author information is available at the end of the articlescreening compared to 38 % ... more Full list of author information is available at the end of the articlescreening compared to 38 % in the period without screening, while the proportion for those operated was 32 % and
A health economic evaluation of screening and treatment in patients with adolescent idiopathic br... more A health economic evaluation of screening and treatment in patients with adolescent idiopathic bracing and reduced surgical rates.
Scoliosis, 2012
Background: Early diagnosis of idiopathic scoliosis allows for observation and timely initiation ... more Background: Early diagnosis of idiopathic scoliosis allows for observation and timely initiation of brace treatment in order to halt progression. School scoliosis screening programs were abolished in Norway in 1994 for lack of evidence that the programs improved outcome and for the costs involved. The consequences of this decision are discussed. Objectives: To describe the detection, patient characteristics, referral patterns and treatment of idiopathic scoliosis at a scoliosis clinic during the period 2003-2011, when there was no screening and to compare treatment modalities to the period 1976-1988 when screening was performed. Methods: Patient demographics, age at detection, family history, clinical and radiological charts of consecutive patients referred for scoliosis evaluation during the period 2003-2011, were prospectively registered. Patients were recruited from a catchment area of about 500000 teenagers. Maturity was estimated according to Risser sign and menarcheal status. Severity of pain was recorded by a verbal 5-point scale from no pain to pain at all times. Physical and neurological examinations were conducted. The detector and patient characteristics were recorded. Referral patterns of orthopedic surgeons at local hospitals and other health care providers were recorded. Patient data was obtained by spine surgeons. Treatment modalities in the current period were compared to the period 1976-1988. Results: We registered 752 patients with late onset juvenile and adolescent idiopathic scoliosis from 2003-2011. There were 644 (86%) girls and 108 (14%) boys. Mean age at detection was 14.6 (7-19) years. Sixty percent had Risser sign ≥ 3, whilst 74% were post menarche with a mean age at menarche of 13.2 years. Thirty-one percent had a family history of scoliosis. The mean major curve at first consultation at our clinic was 38°(10°-95°). About 40% had a major curve >40°. Seventy-one percent were detected by patients, close relatives, and friends. Orthopaedic surgeons referred 61% of the patients. The mean duration from detection to the first consultation was 20(0-27) months. The proportion of the average number of patients braced each year was 68% during the period with screening compared to 38% in the period without screening, while the proportion for those operated was 32% and 62%, respectively (p=0.002, OR 3.5, (95%CI 1.6 to 7.5). Conclusion: In the absence of scoliosis screening, lay persons most often detect scoliosis. Many patients presented with a mean Cobb angle approaching the upper limit for brace treatment indications. The frequency of brace treatment has been reduced and surgery is increased during the recent period without screening compared with the period in the past when screening was still conducted.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 10, 1998
A 12 year old male immigrant from Somalia was admitted to hospital after several years of haematu... more A 12 year old male immigrant from Somalia was admitted to hospital after several years of haematuria and dysuria. Microscopic examination of the urine revealed eggs of the Schistosoma haematobium. Urine culture was negative. Cystoscopy showed a characteristic bilharzial tubercle, and numerous sandy patches were also seen. Mucosal biopsy showed schistosoma eggs, some with calcification. There was squamous cell metaplasia and infiltration of plasma cells and eosinofilic granulocytes. The patient was treated with praziquantel 600 mg x 4 for two days. Three months later no schistosoma eggs were seen in his urine and cystoscopy was negative. In immigrants from countries where bilharzia is endemic, it should be considered a differential diagnosis in patients with haematuria.
Spine, 2010
Cross-sectional study in patients with adolescent idiopathic scoliosis (AIS). To evaluate the rep... more Cross-sectional study in patients with adolescent idiopathic scoliosis (AIS). To evaluate the repeatability, reliability, internal consistency, and concurrent validity (CD) of an adapted Norwegian version of the Scoliosis Research Society 22 questionnaire (SRS-22) and the generic health-related quality of life instrument EuroQol (EQ-5D and EQ-VAS). SRS-22 is widely used for evaluation of health-related quality of life in AIS. Its repeatability, which is essential for use in follow-up studies, and CD with EuroQol which can be used for cost-utility analysis, has not yet been assessed. The forward-backward translation of the English version of the SRS-22 was performed according to guidelines for cross-cultural adaptation of outcome questionnaires. Fifty-seven patients of various ages with AIS and deformity severity filled out standardized questionnaires: SRS-22, EQ-5D, and EQ-VAS, each twice in a 2-week interval. The study was approved by the Regional Ethics Committee for Medical Research in Norway. There were no floor or ceiling effects on the score distributions. The study demonstrated moderate internal consistency and high reliability of SRS-22 questionnaire with Chronbach alpha and intraclass correlation coefficiency ranging from 0.76 to 0.93 for the 5 domains. Repeatability was excellent for all SRS-22 domains with repeatability coefficients <1. CD with EQ-5D was poor to moderate with Pearson's r ranging from 0.14 to 0.58. However, total scores of the 2 instruments showed satisfactory agreement. The SRS-22 outcome instrument has satisfactory repeatability, but CD with EQ-5D suggests that the disease-specific and the generic questionnaire measure different constructs.
Background: School screening for adolescent idiopathic scoliosis (AIS) is discussed. The aim of t... more Background: School screening for adolescent idiopathic scoliosis (AIS) is discussed. The aim of the present study was to describe the point prevalence of AIS and to evaluate the effectiveness of school screening in 12-yearold children. Methods: Community nurses and physical therapists in the Southern Health region of Norway including about 12000 school children aged 12 years were invited to participate. All participating community nurses and physical therapists fulfilled an educational course to improve their knowledge about AIS and learn the screening procedure including the Adam Forward Bending Test and measurement of gibbus using a scoliometer. Results: Sub-regions including 4000 school children participated. The prevalence of idiopathic scoliosis defined as a positive Adam Forward Bending Test, gibbus > 7° and primary major curve on radiographs > 10°, was 0.55%. Five children (0.13%) had a major curve > 20°. Bracing was not indicated in any child; all children were post...
School screening and point prevalence of adolescent idiopathic scoliosis in 4000 Norwegian childr... more School screening and point prevalence of adolescent idiopathic scoliosis in 4000 Norwegian children aged 12 years
Spine Deformity, 2021
PURPOSE While the Scoliosis Research Society (SRS) has established criteria for brace initiation ... more PURPOSE While the Scoliosis Research Society (SRS) has established criteria for brace initiation in adolescent idiopathic scoliosis (AIS), there are no recommendations concerning other management issues. As the BrAIST study reinforced the utility of bracing, the SRS Non-Operative Management Committee decided to evaluate the consensus or discord in AIS brace management. METHODS 1200 SRS members were sent an online survey in 2017, which included 21 items concerning demographics, bracing indications, management, and monitoring. Free-text responses were analyzed and collated into common themes. Data were analyzed using Microsoft Excel 2013. RESULTS Of 218 respondents; 207 regularly evaluate and manage patients with AIS, and 205 currently prescribe bracing. 99% of respondents use bracing for AIS and the majority (89%) use the published SRS criteria, or a modified version, to initiate bracing. 85% do not use brace monitoring and 66% use both %-Cobb correction and fit criteria to evaluate brace adequacy. In contrast, other aspects of brace management demonstrated a high degree of practice variability. This was seen with a radiographic assessment of maturity level, hours prescribed, timing and frequency of radiographic evaluation, the use of nighttime bracing only, and the method and timing of brace discontinuation. CONCLUSION Although there is consensus in brace management amongst SRS members with respect to brace initiation and evaluation of adequacy, there is striking variability in how bracing for AIS is used. This variability may impact the overall efficacy of brace treatment and may be decreased with more robust guidelines from the SRS. LEVEL OF EVIDENCE III.
Tidsskrift for Den norske legeforening, 2016
Tidsskrift for Den norske legeforening
Full list of author information is available at the end of the articlescreening compared to 38 % ... more Full list of author information is available at the end of the articlescreening compared to 38 % in the period without screening, while the proportion for those operated was 32 % and
A health economic evaluation of screening and treatment in patients with adolescent idiopathic br... more A health economic evaluation of screening and treatment in patients with adolescent idiopathic bracing and reduced surgical rates.
Scoliosis, 2012
Background: Early diagnosis of idiopathic scoliosis allows for observation and timely initiation ... more Background: Early diagnosis of idiopathic scoliosis allows for observation and timely initiation of brace treatment in order to halt progression. School scoliosis screening programs were abolished in Norway in 1994 for lack of evidence that the programs improved outcome and for the costs involved. The consequences of this decision are discussed. Objectives: To describe the detection, patient characteristics, referral patterns and treatment of idiopathic scoliosis at a scoliosis clinic during the period 2003-2011, when there was no screening and to compare treatment modalities to the period 1976-1988 when screening was performed. Methods: Patient demographics, age at detection, family history, clinical and radiological charts of consecutive patients referred for scoliosis evaluation during the period 2003-2011, were prospectively registered. Patients were recruited from a catchment area of about 500000 teenagers. Maturity was estimated according to Risser sign and menarcheal status. Severity of pain was recorded by a verbal 5-point scale from no pain to pain at all times. Physical and neurological examinations were conducted. The detector and patient characteristics were recorded. Referral patterns of orthopedic surgeons at local hospitals and other health care providers were recorded. Patient data was obtained by spine surgeons. Treatment modalities in the current period were compared to the period 1976-1988. Results: We registered 752 patients with late onset juvenile and adolescent idiopathic scoliosis from 2003-2011. There were 644 (86%) girls and 108 (14%) boys. Mean age at detection was 14.6 (7-19) years. Sixty percent had Risser sign ≥ 3, whilst 74% were post menarche with a mean age at menarche of 13.2 years. Thirty-one percent had a family history of scoliosis. The mean major curve at first consultation at our clinic was 38°(10°-95°). About 40% had a major curve >40°. Seventy-one percent were detected by patients, close relatives, and friends. Orthopaedic surgeons referred 61% of the patients. The mean duration from detection to the first consultation was 20(0-27) months. The proportion of the average number of patients braced each year was 68% during the period with screening compared to 38% in the period without screening, while the proportion for those operated was 32% and 62%, respectively (p=0.002, OR 3.5, (95%CI 1.6 to 7.5). Conclusion: In the absence of scoliosis screening, lay persons most often detect scoliosis. Many patients presented with a mean Cobb angle approaching the upper limit for brace treatment indications. The frequency of brace treatment has been reduced and surgery is increased during the recent period without screening compared with the period in the past when screening was still conducted.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 10, 1998
A 12 year old male immigrant from Somalia was admitted to hospital after several years of haematu... more A 12 year old male immigrant from Somalia was admitted to hospital after several years of haematuria and dysuria. Microscopic examination of the urine revealed eggs of the Schistosoma haematobium. Urine culture was negative. Cystoscopy showed a characteristic bilharzial tubercle, and numerous sandy patches were also seen. Mucosal biopsy showed schistosoma eggs, some with calcification. There was squamous cell metaplasia and infiltration of plasma cells and eosinofilic granulocytes. The patient was treated with praziquantel 600 mg x 4 for two days. Three months later no schistosoma eggs were seen in his urine and cystoscopy was negative. In immigrants from countries where bilharzia is endemic, it should be considered a differential diagnosis in patients with haematuria.
Spine, 2010
Cross-sectional study in patients with adolescent idiopathic scoliosis (AIS). To evaluate the rep... more Cross-sectional study in patients with adolescent idiopathic scoliosis (AIS). To evaluate the repeatability, reliability, internal consistency, and concurrent validity (CD) of an adapted Norwegian version of the Scoliosis Research Society 22 questionnaire (SRS-22) and the generic health-related quality of life instrument EuroQol (EQ-5D and EQ-VAS). SRS-22 is widely used for evaluation of health-related quality of life in AIS. Its repeatability, which is essential for use in follow-up studies, and CD with EuroQol which can be used for cost-utility analysis, has not yet been assessed. The forward-backward translation of the English version of the SRS-22 was performed according to guidelines for cross-cultural adaptation of outcome questionnaires. Fifty-seven patients of various ages with AIS and deformity severity filled out standardized questionnaires: SRS-22, EQ-5D, and EQ-VAS, each twice in a 2-week interval. The study was approved by the Regional Ethics Committee for Medical Research in Norway. There were no floor or ceiling effects on the score distributions. The study demonstrated moderate internal consistency and high reliability of SRS-22 questionnaire with Chronbach alpha and intraclass correlation coefficiency ranging from 0.76 to 0.93 for the 5 domains. Repeatability was excellent for all SRS-22 domains with repeatability coefficients <1. CD with EQ-5D was poor to moderate with Pearson's r ranging from 0.14 to 0.58. However, total scores of the 2 instruments showed satisfactory agreement. The SRS-22 outcome instrument has satisfactory repeatability, but CD with EQ-5D suggests that the disease-specific and the generic questionnaire measure different constructs.