Ragnhild Elisabeth Monsen

• Monsen, Ragnhild Elisabeth; Lerdal, Anners; Gay, Caryl; Nordgarden, Hilde & Herlofson, Bente Brokstad (2024). A comparison of the prevalence of dry mouth and other symptoms using two different versions of the Edmonton Symptom Assessment System on an inpatient palliative care unit. BMC Palliative Care. ISSN 1472-684X. 23(1). doi: 10.1186/s12904-024-01405-7. Full text in Research Archive
• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2023). Identification and susceptibility testing of oral candidiasis in advanced cancer patients. BMC Oral Health. ISSN 1472-6831. 23(1). doi: 10.1186/s12903-023-02950-y. Full text in Research Archive
• Jones, Jac A.; Chavarri-Guerra, Yanin; Corrêa, Luisa Barreto Costa; Dean, David R.; Epstein, Joel B. & Fregnani, Eduardo R. [Show all 18 contributors for this article] (2022). MASCC/ISOO expert opinion on the management of oral problems in patients with advanced cancer. Supportive Care in Cancer. ISSN 0941-4355. doi: 10.1007/s00520-022-07211-2. Show summary

  Purpose: The Palliative Care Study Group in conjunction with the Oral Care Study Group of the Multinational Association for Supportive Care in Cancer (MASCC) formed a sub-group to develop evidence-based guidance on the management of common oral problems in patients with advanced cancer. Methods: This guidance was developed in accordance with the MASCC Guidelines Policy. A search strategy for Medline was developed, and the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were explored for relevant reviews and trials, respectively. Guidance was categorised by the level of evidence, and “category of guideline” (i.e., “recommendation”, “suggestion” or “no guideline possible”). Results: Twelve generic suggestions (level of evidence – 5), three problem-specific recommendations and 14 problem-specific suggestions were generated. The generic suggestions relate to oral hygiene measures, assessment of problems, principles of management, re-assessment of problems and the role of dental/oral medicine professionals. Conclusions: This guidance provides a framework for the management of common oral problems in patients with advanced cancer, although every patient requires individualised management.

• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Fjeld, Katrine Gahre; Hove, Lene Hystad & Malterud, Karl Egil [Show all 11 contributors for this article] (2021). A mouth rinse based on a tea solution of Salvia officinalis for oral discomfort in palliative cancer care: A randomized controlled trial. Supportive Care in Cancer. ISSN 0941-4355. doi: 10.1007/s00520-021-06021-2. Full text in Research Archive Show summary

  Background: Few clinical studies evaluate interventions to reduce oral discomfort among patients in palliative care. Aim: This study examines the efficacy of a Salvia officinalis (SO) based herbal mouth rinse compared to conventional normal saline (NS) in order to improve oral health. Design: A block-randomized controlled trial. Data were collected before and after a 4-day intervention with either SO (n=44) or NS (n=44). Numerical rating scales (NRS, 0-10) and 12 items from the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Oral Health 17 (EORTC QLQ-OH17) measured patient-reported oral symptoms. An oral examination was performed before and after the intervention. Setting/participants: This study included adult patients with late-stage cancer in an inpatient hospice unit. Results: Of the 88 patients included (mean age=63.9 years, SD=10.6), 73 (83%) completed the study. At baseline, 78% reported dry mouth on the EORTC QLQ-OH17, and 80% rated dry mouth ≥4 on the NRS. Total oral health scores based on the 12 EORTC QLQ-OH17 items improved similarly in both groups (p

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• Monsen, Ragnhild Elisabeth; Carlsen, Britt & Scheibert, Lisa (2023). Children as next-of-kin – how did we care for them during the pandemic?
• Monsen, Ragnhild Elisabeth & Dagestad, Anine (2022). Lindrende dagbehandling - et tilbud til personer med alvorlig lungelidelse. Fagblad for lungesykepleiere. ISSN 0807-1241.
• Monsen, Ragnhild Elisabeth; Nordgarden, Hilde; Gay, Caryl; Lerdal, Anners & Herlofson, Bente Brokstad (2022). Munntørrhet - et manglende symptom i Edmonton Symptom Assessment System?
• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2022). Orale soppinfeksjoner - mer enn Candida albicans: mikrobiologiske analyser av prøver fra alvorlig syke pasienter med kreft . Show summary

  Bakgrunn Pasienter med alvorlig kreftsykdom er utsatte for orale soppinfeksjoner, grunnet sykdommen, kreftbehandling og/eller svekket immunforsvar. Orale soppinfeksjon påvirker pasienters matlyst, ernæringstilstand og livskvalitet. Candida albicans er en vanlig soppart i munnhulen, men forekomst av non-albicans Candida-arter, og i kombinasjon med C. albicans, er økende. Artene har varierende toleranse for antimykotiske midler, det kan gi behandlingsutfordringer. Hensikten med studien var å identifisere og resistensteste Candida sopparter i munnhulen til alvorlig syke pasienter med kreft. Metode Sopprøver tatt under studien Oral Health in Advanced Cancer i perioden 2014 – 2016, ble analysert høsten 2020. Pasientprøvene ble re-dyrket ved Institutt for oral biologi, Universitetet i Oslo. Soppartene ble identifisert biokjemisk og ved DNA sekvensering, og resistenstestet for antimykotiske legemidler: fluconazole, amphotericin B, anidulafungin og nystatin. Resultat Vi analyserte totalt 56 isolater fra 45 pasienter og identifiserte syv Candida arter og en Saccharomyces. Til sammen hadde 36 pasienter oppvekst av én soppart, og 9 pasienter hadde 2 til 3 ulike sopparter i munnhulen. Av C. albicans artene var 39 av 40 følsomme for fluconazole. To Candida parapsilosis og en Candida tropicalis var resistent mot anidulafungin. En C. tropicalis var resistent mot anidulafungin. En Candida glabrata var resistent mot fluconazole. Konklusjon Studien viste at forskjellige Candida arter forekommer både i monoinfeksjoner og blandingsinfeksjoner. C. albicans var dominerende med høy følsomhet for antimykotiske midler. Blandingsinfeksjoner kan komplisere behandlingen og forårsake gjentagende infeksjoner. Mikrobiologiske prøver og analyser med identifisering og resistenstesting, bør være en del av utredningen hos pasienter med alvorlig og tilbakevendende orale soppinfeksjoner.

• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2022). Oral candidiasis in advanced cancer – identification and susceptibility testing of detected Candida species. Show summary

  Introduction: Candida albicans is the most common fungal species in the oral cavity. Increased prevalence of non-C. albicans are detected, and co-infection with C. albicans may have implications for treatment, due to antifungal resistance. The aim of the study was to assess the diversity and susceptibility of oral yeasts in patients with advanced cancer. Methods: Clinical fungal isolates were sampled in 2014-2016 from 45 patients in a hospice unit. Totally 56 isolates were grown on chromID Candida plates, prepared for biochemical identification, and controlled with DNA sequencing. E-test was performed with the antifungal agents fluconazole, amphotericin B, anidulafungin and nystatin were tested. Results: A total of 56 isolates were identified. Candida species was dominated by C. albicans at 71%, followed by C. glabrata 9%, C. parapsilosis 5%, C. tropicalis 4%, C. krusei 2%, C. guilliermondii 2% and C. dubliniesis 2%. Nine patients had 2-3 different species. C. albicans strains were susceptible to fluconazole in 97.5%. One C. parapsilosis and one C. tropicalis strain were resistant to anidulafungin. One C. glabrata was resistant to fluconazole and another was just below the threshold for resistance. The sequencing confirmed the biochemical identification. Conclusion: C. albicans was the most prevalent species. Variation in susceptibility was observed in patients with mixed colonies. Combinations of Candida species and the lack of identification and susceptibility testing may lead to inadequate treatment.

• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2022). Identification and susceptibility testing of oral candidiasis in advanced cancer patients – an important diagnostic tool. Show summary

  Background: Candida albicans is the most common fungal species detected in the oral cavity. Studies of oral fungal samples have shown an increased prevalence of non-C. albicans species in mixed infection with C. albicans. Non-C. albicans and C. albicans are associated with varying degrees of resistance to azole. This may have implications for treatment, due to acquired antifungal resistance. Aims: To assess the diversity and susceptibility of detected Candida species in the oral cavity in patients with advanced cancer. Methods: Clinical fungal isolates sampled in 2014-2016 from 45 patients in a hospice unit were analyzed. A total of 56 isolates were grown on chromID Candida plates. After phenotypic identification by colour of the colonies, one single colony of each species was re-cultivated and prepared for identification on a VITEK2® system. Susceptibility testing with E-test was performed on RPMI agar, and the antifungal agents fluconazole, amphotericin B, anidulafungin and nystatin were tested. Results: A total of 56 Candida isolates were identified. The diversity of Candida species was dominated by C. albicans at 89%, followed by C. glabrata 11%, C. parapsilosis 7%, C. tropicalis 4%, C. krusei 2%, C. guilliermondii 2% and C. dubliniesis 2%. Thirty-six patients had monoculture, and nine patients had 2-3 different species detected. Almost all C. albicans strains (97.5%) were susceptible to fluconazole. One C. parapsilosis and one C. tropicalis strain were resistant to anidulafungin. One C. glabrata was resistant to fluconazole and another was just below the threshold for resistance. Conclusion: C. albicans was the most prevalent Candida species in our sample. Variation in susceptibility was observed in patients with both C. albicans and C. glabrata. Combinations of Candida species and the lack of identification and susceptibility testing may lead to inadequate treatment and accelerate the development of resistance.

• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Dahl, Marianne; Saghaug, Elisabeth & Slaaen, Joran [Show all 7 contributors for this article] (2019). Dry mouth - a missing symptom in multiple assessment tools?
• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Fjeld, Katrine Gahre; Hove, Lene Hystad & Saghaug, Elisabeth [Show all 10 contributors for this article] (2019). A comparison of normal saline mouth rinse and mouth rinse based on Salvia officinalis in palliative care: A randomized controlled trial.
• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Saghaug, Elisabeth; Tollisen, Anita & Fjeld, Katrine Gahre [Show all 10 contributors for this article] (2018). Rekruttering av pasienter til en klinisk intervensjonsstudie i et Hospice.
• Dahl, Marianne; Monsen, Ragnhild Elisabeth & Lindahl, Rigmor V (2017). Frivillig arbeid på et hospice i spesialisthelsetjenesten. Omsorg: Nordisk tidsskrift for Palliativ Medisin. ISSN 0800-7489. p. 29–32.
• Monsen, Ragnhild Elisabeth; Dahl, Marianne & Lindahl, Rigmor V (2017). Våk med meg - erfaringer fra opprettelsen av våketjenesten med frivillige ved Hospice Lovisenberg. Omsorg: Nordisk tidsskrift for Palliativ Medisin. ISSN 0800-7489. p. 33–36.
• Gay, Caryl; Monsen, Ragnhild Elisabeth; Saghaug, Elisabeth; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 11 contributors for this article] (2017). Oral health symptoms that interfere with eating and drinking among hospice patient.
• Monsen, Ragnhild Elisabeth; Saghaug, Elisabeth; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre; Hove, Lene Hystad & Tallang, Oddveig Utheim [Show all 10 contributors for this article] (2016). Munntørrhet hos palliative pasienter - en randomisert kontrollert studie i en hospiceenhet.
• Monsen, Ragnhild Elisabeth; Saghaug, Elisabeth; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre; Hove, Lene Hystad & Tollissen, Anita [Show all 8 contributors for this article] (2015). Munnskylling med te av Salvia Officinalis som del av palliativ behandling - fra gode erfaringer til en klinisk forskningsstudie.
• Monsen, Ragnhild Elisabeth & Sundal, Tone (2013). Som ringer i vann. Omsorg: Nordisk tidsskrift for Palliativ Medisin. ISSN 0800-7489. p. 31–45.
• Monsen, Ragnhild Elisabeth & Sundal, Tone (2013). Competence improvement in palliative care in nursing homes - a co-operation between municipal health care and specialist healt care in Oslo.
• Monsen, Ragnhild Elisabeth & Sundal, Tone (2012). Som ringer i vann... kompetanseheving i lindrende behandling 2011 - 2015.

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