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Ragnhild S Falk,1 Trond Heir,2,3 Trude E Robsahm,4 Steinar Tretli,4 Leiv Sandvik,1 Jan E Erikssen,2 Jan E Paulsen5 1Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway; 2Oslo Ischemia study, Oslo University Hospital, Oslo, Norway; 3Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; 4Department of Research, Cancer Registry of Norway, Oslo, Norway; 5Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, Oslo, NorwayCorrespondence: Ragnhild S FalkOslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Pb 4950 Nydalen, Oslo 0424, NorwayTel +47 23 06 60 13Email rs@ous-hf.noPurpose: To examine whether serum levels of potassium and sodium were associated with long-term cancer risk in initially healthy men.Patients and Methods: A cohort of 1994 initially healthy men with no use of medication, aged 40–59 years, was followed for cancer during 40 years of follow-up. Associations between fasting electrolyte levels and cancer risk were assessed with incidence rates and Cox proportional hazards models.Results: Potassium, but not sodium, was linearly associated with cancer risk. This association remained significant after adjustment of several potential confounding factors, and also after excluding the first 10 years of follow-up. The age-adjusted risk of all-site cancer increased with 16% for each SD increase in potassium level. Men with hyperkalemia showed an incidence rate that was 40% higher than for men with normal potassium levels.Conclusion: Fasting serum potassium level in healthy men was positively associated with long-term cancer risk. Potassium or potassium ion channels may have a role in cell proliferation or differentiation. These findings might imply future cancer strategies for targeting individuals with high serum potassium levels.Keywords: cancer incidence, cell proliferation, electrolyte levels, epidemiology, prospective cohort study

Fredrik Hetmann,1 Ulf E Kongsgaard,2,3 Leiv Sandvik,4 Inger Schou-Bredal3,5 1Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, 2Division of Emergencies and Critical Care, Department of Anaesthesiology, Oslo University Hospital, 3Medical Faculty, University of Oslo, 4Department of Biostatistics and Epidemiology, Division of Oslo Hospital Services, 5Department of Breast and Endocrine Surgery, Division of Cancer and Surgery, Oslo University Hospital, Oslo, Norway Background: Persistent pain affects a large proportion of patients after thoracotomy and is associated with sensory disturbances. The objective of this prospective study was to investigate the time course of pain and sensory disturbances over a 12-month period. Methods: Patients scheduled for thoracotomy were recruited. Data were collected on the day before surgery, including baseline characteristics and the presence of any preoperative pain. At 6- and 12-month follow-ups, data on pain were collected using the Brief Pain Inventory-Short Form, and perceived sensory disturbances around the thoracotomy scar were recorded from a self-exploration test. Results: At 12 months after surgery, 97 patients had complete data including baseline and 6- and 12-month measurements. Almost half of the patients reported post-thoracotomy pain at the follow-ups. However, 20% of the patients not reporting post-thoracotomy pain at 6 months did report it at 12 months. Between 40% and 60% of patients experienced some kind of sensory disturbance at 6 months. A small decline in some kind of sensory disturbance was reported by 20%–50% of patients at 12 months. Conclusion: A proportion of patients experienced either resolved or delayed onset of pain. Sensory changes were strongly associated with post-thoracotomy pain syndrome, but were also present in a large proportion of patients without it. Keywords: pain, post-thoracotomy pain syndrome, chronic pain, thoracic surgery, sensory disturbance, delayed pain

Objective: To assess the association between preterm first birth and preterm second birth according to gestational age and to determine the role of placental disorder in recurrent preterm birth. Design: Population‐based registry study. Setting: Medical Birth Registry of Norway and Statistics Norway. Population: Women (n = 213 335) who gave birth to their first and second singleton child during 1999–2014 (total n = 426 670 births). Methods: Multivariate logistic regression analyses, adjusted for placental disorders, maternal, obstetric and socio‐economic factors. Main outcome measures: Extremely preterm (<28+0 weeks), very preterm (28+0–33+6 weeks) and late preterm (34+0–36+6 weeks) second birth. Results: Preterm birth (<37 weeks) rates were 5.6% for first births and 3.7% for second births. Extremely preterm second births (0.2%) occurred most frequently among women with an extremely preterm first birth (aOR 12.90, 95% CI 7.47–22.29). Very preterm second births (0.7%) occurred most frequently after an extremely preterm birth (aOR 12.98, 95% CI 9.59–17.58). Late preterm second births (2.8%) occurred most frequently after a previous very preterm birth (aOR 6.86, 95% CI 6.11–7.70). Placental disorders contributed 30–40% of recurrent extremely and very preterm births and 10–20% of recurrent late preterm birth. Conclusion: A previous preterm first birth was a major risk factor for a preterm second birth. The contribution of placental disorders was more pronounced for recurrent extremely and very preterm birth than for recurrent late preterm birth. Among women with any category of preterm first birth, more than one in six also had a preterm second birth (17.4%). Preterm first birth is a major risk factor for subsequent preterm birth, regardless of maternal, obstetric or fetal risk factors. Preterm first birth is a major risk factor for subsequent preterm birth, regardless of maternal, obstetric or fetal risk factors. This article includes Author Insights, a video abstract available at: https://vimeo.com/bjog/authorinsights17013 [ABSTRACT FROM AUTHOR]