Jens Vikse

• MD. PhD candidate
• Consultant rheumatologist at Stavanger University Hospital

Objectives. Severe coronavirus disease 2019 (COVID-19) is associated with a dysregulated immune state. While research has focused on the hyperinflammation, little research has been performed on the compensatory anti-inflammatory response. The aim of this study was to evaluate the anti-inflammatory cytokine response to COVID-19, by assessing interle...

Background We investigated sensitivity of the 2020 Revised Comprehensive Diagnostic Criteria (RCD) and the 2019 ACR/EULAR classification criteria across the four identified IgG4-related disease (IgG4-RD) phenotypes: “Pancreato-Hepato-Biliary”, “Retroperitoneum and Aorta”, “Head and Neck-limited” and “Mikulicz’ and Systemic” in a well-characterized...

Background Drugs used to treat rheumatic disease are associated with pneumotoxicity (drug-induced lung disease), but little is known about associated risk factors. Aim To determine expert physician-perceived risk factors for developing pneumotoxicity in patients with rheumatologic conditions. Methods A modified international 3-tier Delphi exercis...

Background The IgG4-related disease (IgG4-RD) responder index (RI) is a validated tool to assess disease activity in IgG4-RD [1]. The RI reflects symptoms attributable to active IgG4-RD as well as relevant findings from the physical examination, imaging and laboratory evaluations, with higher scores reflecting more active disease. Multiorgan involv...

Background Milestones in the field of IgG4-related disease (IgG4-RD) include the 2011 Comprehensive Diagnostic Criteria (CDC) (1), the 2019 ACR/EULAR classification criteria (2), and the recent identification of four distinct clinical phenotypes (3). Performance of the criteria and phenotypic disease expression in Scandinavian populations are large...

Background IgG4-related disease (IgG4-RD) is a rare, heterogenous and potentially severe disease. An open-label trial demonstrated efficacy of rituximab (RTX) in IgG4-RD [1]. Recently, four distinct phenotypes of IgG4-RD were identified [2]. There is a paucity of studies investigating RTX efficacy across these phenotypes. Objectives Investigate ef...

COVID-19 is now established to be associated with a thrombotic phenomenon, now called COVID-19 associated coagulopathy (CAC). Anti-Endothelial Cell Antibodies (AECA) are a heterogenous group of autoantibodies targeting various endothelial cell antigens or antigens adhering to endothelial cells, They are commonly observed in a variety of auto-immune...

COVID-19 is now established to be associated with a thrombotic phenomenon, now called COVID-19 associated coagulopathy (CAC). Anti-Endothelial Cell Antibodies (AECA) are a heterogenous group of autoantibodies targeting various endothelial cell antigens or antigens adhering to endothelial cells, They are commonly observed in a variety of auto-immune...

Objective: We performed a systematic review and meta-analysis for exploring clinical benefits and safety of tocilizumab in addition to standard of care (SOC) in treating patients with coronavirus disease 2019 (COVID-19). Methods: An electronic search was carried out in PubMed, EMBASE, Cochrane Library, and Science Direct, as well as in medRxiv prep...

Objective Extracorporeal Membrane Oxygenation (ECMO) may serve as a life-saving rescue therapy in critically ill children with respiratory failure. While survival rates of ECMO in children with secondary immunodeficiency is considered relatively poor, survival rates in children with primary immunodeficiencies (PID) has yet to be thoroughly investig...

Background Complement system hyperactivation has been proposed as a potential driver of adverse outcomes in severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infected patients, given prior research of complement deposits found in tissue and blood samples, as well as evidence of clinical improvement with anticomplement therapy. Its role i...

Background: There is a compelling need to identify clinical and laboratory predictors of unfavorable clinical course and death in patients with coronavirus disease (COVID-19). A trend towards low lymphocyte count and high neutrophil counts in patients with poor outcomes has been reported by earlier studies. We aim to synthesize existing data evalua...

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), shares similarities with the former SARS outbreak, which was caused by SARS-CoV-1. SARS was characterized by severe lung injury due to virus-induced cytopathic effects and dysregulated hyperinflammatory state. COVID-19 has a higher mo...

Coronavirus disease 2019 (COVID-19) infection has now reached a pandemic state, affecting more than a million patients worldwide. Predictors of disease outcomes in these patients need to be urgently assessed to decrease morbidity and societal burden. Lactate dehydrogenase (LDH) has been associated with worse outcomes in patients with viral infectio...

We believe that RAS modulation may have a potential role in treatment of selected patients with severe COVID-19 at risk for ALI/ARDS. Since ACEi can lead to cough secondary to accumulation of bradykinin, we believe ARBs, recombinant ACE2 or Ang1-7 may be more favorable treatment options. Of note, a pilot clinical trial of recombinant ACE2 in ARDS s...

IMMU er en innføring i immunologi for studenter. Læreverket gir en oversikt over immunforsvarets oppbygning og funksjon, og en grunnleggende forståelse av noen av fagets mest sentrale prinsipper. Læreverket består av denne læreboken og 16 tilhørende videoforelesninger på nettsiden www.immu.no. IMMU brukes av norske medisinstudenter i både inn-og...

Rituximab, an anti-CD20 monoclonal antibody causing selective B-cell depletion, is used for various systemic inflammatory and autoimmune diseases (SIADs). Long-term safety data on rituximab are limited. The objectives of this study were to evaluate the long-term safety and tolerability of rituximab treatment for SIADs. A retrospective, single-cente...

Background: Uveitis and acute renal failure can be seen in various immune-mediated systemic diseases. Here we present a case of a young man with a rare inflammatory oculorenal syndrome. Case report: A man in his thirties was admitted with a constellation of fatigue, flank pain, weight loss and bilateral acute anterior uveitis. Laboratory tests s...

Background: Purple urine bag syndrome (PUBS) can occur in cases of bacteriuria with species expressing enzymes capable of converting tryptophan metabolites to red and blue pigments which are excreted in urine, leaving a characteristic purple colour. Risk factors include urinary catheterisation, constipation and chronic kidney disease. Treatment in...

Purpose The anatomy of parathyroid glands (PTG) is highly variable in the population. The aim of this study was to conduct a systematic analysis on the prevalence and location of PTG in healthy and hyperparathyroidism (HPT) patients. Methods An extensive search of the major electronic databases was conducted to identify all studies that reported r...

PURPOSE: Accumulating evidence suggests that fatigue in chronic inflammatory diseases is generated in the brain by mechanisms involving proinflammatory cytokines. We recently reported a high prevalence of fatigue in patients with mastocytosis, a condition with a constant activation of mast cells and release of a variety of bioactive substances. Thi...

Koronararterieaneurismer kan oppstå som følge av blant annet aterosklerose og enkelte revmatiske sykdommer. Her presenteres en mann med høy kardiovaskulær risikoprofil, ST- elevasjonsinfarkt og funn av aneurismer i flere koronararterier.

Surgical closure of a patent ductus arteriosus (PDA) is considered standard treatment for symptomatic neonates refractory to medical therapy. Sometimes, iatrogenic injury to the left recurrent laryngeal nerve during the procedure can result in vocal cord paralysis (VCP). This study aimed to estimate the incidence of VCP in patients after surgical P...

The association of FokI (rs2228570), a polymorphism of the vitamin D receptor gene, with intervertebral disc degeneration (IDD) has been investigated in a multitude of studies. However, conflicting results of these studies led to emergence of several meta-analyses over the past few years. Despite the increased statistical power, these meta-analyses...

Unambiguous reporting of a study's compliance with ethical guidelines in anatomical research is imperative. As such, clear, universal, and uniform reporting guidelines for study ethics are essential. In 2016, the International Evidence-Based Anatomy Working group in collaboration with international partners established reporting guidelines for anat...

Introduction: Children with malignancies show a significantly higher incidence of morphological anomalies (head, eye, nose, ear, trunk, rib and spine anomalies and defects) than “their” healthy counterparts. Cervical ribs (CR) are supernumerary ribs that emerge from seventh cervical vertebra. Aim: This meta-analysis aimed to investigate the preval...

Sarcoidosis is characterised by granulomatous inflammation in one or more organs, including the heart. Cardiac sarcoidosis generally has non-specific symptoms, and the disease is often diagnosed at a late stage. The condition is associated with cardiomyopathy and arrhythmia and may be fatal.

Booklet serving as supplement to the video lectures found on www.immu.no. immu.no is an educational platform providing Norwegian medical students with an introduction to basic immunology. First edition 2017. Second edition february 2018. Copyright (C) 2017 and 2018 by Jens Vikse. All rights reserved. No part of this publication (or related mat...

Two main types of review articles with distinct characteristics and goals are commonly found in the scientific literature: systematic reviews and narrative (also called expert or traditional) reviews. Narrative reviews are publications that describe and discuss the state of science on a specific topic or theme from a theoretical and contextual poin...

Clear reporting of original studies is an integral part of evidence-based principles, which the basic sciences, including anatomy, have only recently begun to adapt to. Evidence-based anatomy (EBA), is a developing field of anatomical research which employs evidence-based methods such as meta-analyses, systematic reviews, and high-quality original...

Background: Cervical ribs (CR) are supernumerary ribs that arise from the seventh cervical vertebra. In the presence of CR, the boundaries of the interscalene triangle can be further constricted and result in neurovascular compression and Thoracic Outlet Syndrome (TOS). The aim of our study was to provide a comprehensive evidence-based assessment...

Purpose: Corona mortis is a highly variable vascular connection between the obturator and external iliac or inferior epigastric arteries or veins located behind the superior pubic ramus in the retropubic space (space of Retzius). Due to the significant variation in this collateral circulation, detailed anatomical knowledge of the corona mortis is...

Background: An accessory spleen (AS) is a lobule of splenic tissue found in ectopic locations. Identification of AS is particularly important in patients with immune thrombocytopenia (ITP) requiring splenectomy as unrecognized AS can later cause refractory symptoms. The AS can also be a source of significant intraabdominal hemorrhage. The aim of th...

OBJECTIVE: The foramen arcuale (FA) is a bony bridge located over the vertebral artery on the posterior arch of the atlas. The presence of an FA can pose a risk during neurosurgery by providing a false impression of a broader posterior arch. The aim of this study was to provide the most comprehensive investigation on the prevalence of the FA and it...

Purpose: Recurrent laryngeal nerve (RLN) injury is one of the most common and detrimental complications following thyroidectomy. Intermittent intraoperative nerve monitoring (I-IONM) has been proposed to reduce prevalence of RLN injury following thyroidectomy and has gained increasing acceptance in recent years. Methods: A comprehensive database s...

Ordene hypoksi og hypoksemi oppfattes av mange som synonymer, men beskriver ulike prosesser. Den populære frasen «blodgass viste hypoksi» bør unngås, da en arteriell blodgassanalyse ikke med sikkerhet kan avgjøre om en pasient er hypoksisk. Nedsatt partielt oksygentrykk (PaO2) og/eller nedsatt oksygensaturasjon (SaO2) i arterielt blod skal omtales...

Objective: Zuckerkandl’s tubercle (ZT), when present, is an anatomical landmark by which surrounding structures such as the recurrent laryngeal nerve (RLN) can be identified intraoperatively. This study aimed to investigate the prevalence and anatomical characteristics of Zuckerkandl’s tubercle by combining cadaveric dissection with a meta-analysi...

Objective: Heart is a vital organ of circulatory system and the measurement of different parts of the heart is an important aspect for studying the anatomy of heart. The aim of this meta-analysis was to study the size of annular diameter, area and circumference as reported by studies on human participants. Methods: Literature search for relevant st...

Background: The Non-Recurrent Laryngeal Nerve (NRLN) is a rare embryologically-derived variant of the Recurrent Laryngeal Nerve (RLN). The presence of an NRLN significantly increases the risk of iatrogenic injury and operative complications. Our aim was to provide a comprehensive meta-analysis of the overall prevalence of the NRLN, its origin, and...

Purpose: The aim of this meta-analysis was to analyze the available literature and provide comprehensive data on the prevalence and variations of accessory pudendal artery (APA) and the three types of penile blood supply (Type 1 - internal pudendal artery (IPA) only, Type 2 - IPA and APA), Type 3 - APA only) Materials and Methods: We conducted an...

Purpose. The aim of this meta-analysis was to provide a comprehensive evidence-based assessment, supplemented by cadaveric dissections, of the value of using the Ligament of Berry and Tracheoesophageal Groove as anatomical landmarks for identifying the Recurrent Laryngeal Nerve. Methods. Seven major databases were searched to identify studies for i...

Objectives: The recurrent laryngeal nerve and its branches form a great variety of anastomoses. These nerve communications can alter the innervation patterns of the laryngeal muscles and can affect both the diagnosis and treatment of paralyzed vocal cords. The aim of this study was to assess the prevalence and anatomical characteristics of the lary...

Introduction: The recurrent laryngeal nerves (RLN) are branches of the vagus nerve that go on to innervate most of the intrinsic muscles of the larynx. Historically, the RLN has been considered to branch after it enters the larynx, but numerous studies have demonstrated that it often branches before. The wide variability of this extralaryngeal bran...

Background: The rise of evidence-based anatomy (EBA) has emphasized the need for original anatomical studies with high clarity, transparency, and comprehensiveness in reporting. Currently, inconsistencies in the quality and reporting of such studies have placed limits on accurate reliability and impact assessment. Our aim was to develop a checklist...

Background: Critical appraisal of anatomical studies is essential before the evidence from them undergoes meta-epidemiological synthesis. However, no instrument for appraising anatomical studies with inherent applicability to different study designs is available. We aim to develop a generic yet comprehensive tool for assessing the quality of anato...

The lateral circumflex femoral artery (LCFA) is responsible for vascularisation of the head and neck of the femur, greater trochanter, vastus lateralis and the knee. The origin of the LCFA has been reported to vary significantly throughout the literature, with numerous branching patterns described and variable distances to the mid-inguinal point re...

Background: The relationship between the recurrent laryngeal nerve (RLN) and inferior thyroid artery (ITA) is highly variable and traceable back to embryological life. Methods: Comprehensive database searches were conducted, followed by judgment of eligibility, assessment, and extraction of data concerning the RLN/ITA relationship. The data were...

Introduction: The superficial fibular (peroneal) nerve (SFN) is one of the successive branches of the common fibular (peroneal) nerve and goes on to bifurcate into the medial dorsal cutaneous (MDN) and intermediate dorsal cutaneous (IDN) nerves. The SFN is a main contributor to sensory innervation of the foot and lower leg. It varies widely in its...

Objectives: The accessory deep peroneal nerve (ADPN) is a common anatomical variant arising from the superficial peroneal nerve (SPN) and, when present, is often responsible for partial or complete innervation of the extensor digitorum brevis muscle (EDBM). The nerve lies posterior to the peroneus brevis muscle, traveling posterior to the lateral...

The image for Fig 1 is incorrect. Please see the corrected Fig 1 here. Fig 1 The various origins of the sinoatrial nodal artery (SANa) as seen from a superior view with their calculated pooled prevalence in the overall population.

Background and Objectives. The medial circumflex femoral artery (MCFA) is a common branch of the deep femoral artery (DFA) responsible for supplying the femoral head and the greater trochanteric fossa. The prevalence rates of MCFA origin, its branching patterns and its distance to the mid-inguinal point (MIP) vary significantly throughout the liter...

Background and objective: The sinoatrial nodal artery (SANa) is a highly variable vessel which supplies blood to the sinoatrial node (SAN). Due to its variability and susceptibility to iatrogenic injury, our study aimed to assess the anatomy of the SANa and determine the prevalence of its anatomical variations. Study design: An extensive search...

The sciatic nerve has varying anatomy with respect to the piriformis muscle. Understanding this variant anatomy is vital to avoiding iatrogenic nerve injuries. A comprehensive electronic database search was performed to identify articles reporting the prevalence of anatomical variations or morphometric data of the sciatic nerve. The data found was...

Introduction: The deep femoral artery (DFA) is the largest branch of the femoral artery (FA) and is responsible for vascularization of the thigh muscles. Knowledge of the anatomical variations in its origin point is important for surgeons and interventional radiologists. The aim of our study was to provide a comprehensive evidence-based assessment...

Introduction: The most frequently described anomalous neural connections between the median and ulnar nerves in the upper limb are: Martin-Gruber anastomosis (MGA), Marinacci anastomosis (MA), Riche-Cannieu anastomosis (RCA), and Berrettini anastomosis (BA). The reported prevalence rates and characteristics of these anastomoses vary significantly...

Background and Objectives. The accessory head of the flexor pollicis longus muscle (AHFPL), also known as the Gantzer’s muscle, was first described in 1813. The prevalence rates of an AHFPL significantly vary between studies, and no consensus has been reached on the numerous variations reported in its origin, innervation, and relationships to the A...

Several studies have explored the use of serum procalcitonin (PCT) in differentiating between bacterial and viral etiologies in children with suspected meningitis. We pooled these studies into a meta-analysis to determine the PCT diagnostic accuracy. All major databases were searched through March 2015. No date or language restrictions were applied...

Background and objective: The course and branches of the median nerve (MN) in the wrist vary widely among the population. Due to significant differences in the reported prevalence of such variations, extensive knowledge on the anatomy of the MN is essential to avoid iatrogenic nerve injury. Our aim was to determine the prevalence rates of anatomic...

The sural nerve (SN) is a sensory nerve in the lower extremity which branches to supply the skin on the distal posterolateral third of the lower limb. Typically, the medial sural cutaneous nerve (MSCN) and the peroneal communicating nerve (PCN) unite to form the SN. Other variations in the formation, course, and morphometry of the SN have also been...

Clinically it is often difficult to differentiate between bacterial and viral etiologies in adults with suspected meningitis. Several studies have demonstrated the potential use of serum Procalcitonin (PCT) in making this differentiation. Our aim was to pool these studies into a meta-analysis to determine the diagnostic accuracy of PCT. Major elect...

Several studies have attempted to investigate whether variations in the Circle of Willis (COW) are more common in migraine patients and whether the subsequent changes in perfusion may contribute to the pathomechanism of migraine. However, studies are not in agreement as to whether or not there is an increased prevalence of COW variations in migrain...

Probiotics are live microorganisms that when ingested in sufficient amounts may provide a health benefit to the host. Probiotic use has rapidly increased in hospitals and are most often administered to prevent antibiotic-associated diarrhea and gastroenteritis. While probiotics are generally considered safe, there are documented cases in which thei...

Snus is a high-dose smokeless tobacco product commonly used amongst Scandinavian medical students. Compared to cigarettes, a dose of Snus provides 3-8 times higher concentrations of nicotine and has a longer duration of exposure. Nicotine has been show to improve short-term episodic memory, working memory, and attention. It affects memory by acting...