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Adrenal lesion frequency: A prospective, cross-sectional CT study in a defined region, including systematic re-evaluation.

https://arctichealth.org/en/permalink/ahliterature139870
Source
Acta Radiol. 2010 Dec;51(10):1149-56
Publication Type
Article
Date
Dec-2010
Author
Lilian Hammarstedt
Andreas Muth
Bo Wängberg
Lena Björneld
Helga A Sigurjónsdóttir
Galina Götherström
Erik Almqvist
Håkan Widell
Sture Carlsson
Stefan Ander
Mikael Hellström
Author Affiliation
Department of Radiology, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. lilian.hammarstedt@vgregion.se
Source
Acta Radiol. 2010 Dec;51(10):1149-56
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Adrenal Gland Neoplasms - epidemiology - radiography
Adrenal Glands - radiography
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Incidental Findings
Male
Middle Aged
Observer Variation
Prevalence
Prospective Studies
Reproducibility of Results
Sweden - epidemiology
Tomography, X-Ray Computed - methods
Abstract
incidentally detected adrenal lesions have become a growing clinical problem.
to prospectively estimate and validate the prevalence of incidentally detected adrenal lesions (adrenal incidentaloma) in patients with or without malignant disease undergoing CT.
during 18 months all adult patients with incidentally discovered adrenal lesions detected at CT were prospectively reported from the radiology departments of all hospitals in Western Sweden (1.66 million inhabitants). Frequencies of adrenal lesions initially reported at CT and at a systematic re-evaluation were compared. The interobserver variation in blindly assessing adrenal lesions was also analyzed.
adrenal lesions were reported and verified in 339 patients (193 females; mean age 69 years, range 30-94 years). Mean lesion size was 25.8 mm (range 8-94 mm). The mean frequency of originally reported adrenal lesions was 0.9% (range 0-2.4% between hospitals). The systematic re-evaluation of 3801 randomly selected cases showed a mean frequency of 4.5% (range 1.8-7.1% between hospitals). The re-evaluation revealed 177 cases with adrenal lesions, 30% of these were submitted by the local radiologist in accordance with the study design, 23% were described in the local radiology report but not submitted to the study center, while 47% were neither locally reported nor submitted.
adrenal lesions are under-reported in clinical practice. Prevalence figures for adrenal incidentalomas should therefore be interpreted with caution, especially in multi-center settings.
PubMed ID
20969508 View in PubMed
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Difficulties in using interpreters in clinical encounters as experienced by immigrants living in Sweden.

https://arctichealth.org/en/permalink/ahliterature281583
Source
J Clin Nurs. 2016 Jun;25(11-12):1721-8
Publication Type
Article
Date
Jun-2016
Author
Ferid Krupic
Mikael Hellström
Mirza Biscevic
Sahmir Sadic
Nabi Fatahi
Source
J Clin Nurs. 2016 Jun;25(11-12):1721-8
Date
Jun-2016
Language
English
Publication Type
Article
Keywords
Communication
Communication Barriers
Cultural Competency
Emigrants and Immigrants - statistics & numerical data
Female
Focus Groups
Humans
Male
Middle Aged
Multilingualism
Physician-Patient Relations
Primary Health Care
Qualitative Research
Sweden
Translating
Abstract
To study a group of immigrants' experiences regarding interactions with primary health care through an interpreter.
Approximately, 230 million people are resettled outside of their own home country. Thus, more than 3% of the world's population are migrants. It is a major challenge for health care providers to satisfy immigrants' needs for individualised health care services.
Qualitative study.
Focus group interviews were conducted with four groups of immigrants (n = 24) from Bosnia and Herzegovina, Croatia, Kosovo and Somalia. The group interviews were audio recorded, transcribed and analysed, and the text was categorised using the content analysis method.
Participants' expectations of the interpreter-mediated consultations were high, but not always fulfilled. Interpreters being late, lacking professionalism or lacking knowledge in medical terminology and the use of health care professionals or relatives as interpreters were some of the problems raised.
A well-organised, disciplined interpreter service with professional and competent interpreters is needed to overcome problems regarding clinical consultations involving interpreters. A satisfactory language bridge has a significant impact on the quality of communications.
Interpreter services should be well organised, and interpreters should be linguistically, culturally and socially competent, as these factors may have a significant impact on consultation outcomes. Using relatives or staff as interpreters can sometimes be a solution but often results in an unsatisfactory clinical consultation.
PubMed ID
26879885 View in PubMed
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Experiences of Kurdish war-wounded refugees in communication with Swedish authorities through interpreter.

https://arctichealth.org/en/permalink/ahliterature99023
Source
Patient Educ Couns. 2010 Feb;78(2):160-5
Publication Type
Article
Date
Feb-2010
Author
Nabi Fatahi
Lena Nordholm
Bengt Mattsson
Mikael Hellström
Author Affiliation
Department of Radiology, Sahlgrenska University Hospital and The Sahlgrenska Academy at Gothenburg University, 413 45 Gothenburg, Sweden. nabi.fatahi@allmed.gu.se
Source
Patient Educ Couns. 2010 Feb;78(2):160-5
Date
Feb-2010
Language
English
Geographic Location
Sweden
Multi-National
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Communication
Communication Barriers
Cultural Characteristics
Emigration and Immigration
Humans
Interviews as Topic
Iran - ethnology
Language
Male
Physician-Patient Relations
Refugees - psychology
Sweden
Translating
War
Abstract
OBJECTIVE: To study experiences of war-wounded Kurdish refugees with respect to cross-cultural communication through interpreters. METHOD: Semi-structured interviews were conducted with ten men, aged 31-42. Content analysis was used for analysis and interpretation of data. RESULT: War-wounded Kurdish refugees experienced a number of difficulties regarding communication through interpreters, mainly related to the insufficient language link to the Swedish authorities, particularly health care personnel. In many instances, interpreters were selected based on the immigrant's citizenship rather than mother tongue, leading to a more complex, tri-lingual interpretation situation. Differences in cultural background, fear, suspicion and lack of confidence in interpreters were addressed as other problems by the participants. CONCLUSION: Interpreter competence and patient confidence in the interpreter are essential for an adequate cross-cultural health communication. Assignment of interpreters should be based on knowledge of the patient's/client's mother tongue, rather than citizenship, and the outcome is improved by a common ethnic and cultural background of interpreter and patient/client. Our study should be considered as a pilot study, and the results should be validated in larger cohorts as well as in other ethnic and language groups. PRACTICE IMPLICATIONS: In order to minimize communication misunderstandings, complicated tri-lingual interpretation situations should be avoided. Interpreters should ideally be assigned according to patient's/client's mother tongue rather than citizenship. Interpreters' competence and patient's/client's confidence in interpreter may have significant impact on communication outcome.
Notes
RefSource: Patient Educ Couns. 2010 Feb;78(2):139-40
PubMed ID
19375263 View in PubMed
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Minimal risk of contrast-induced kidney injury in a randomly selected cohort with mildly reduced GFR.

https://arctichealth.org/en/permalink/ahliterature311523
Source
Eur Radiol. 2021 May; 31(5):3248-3257
Publication Type
Journal Article
Date
May-2021
Author
Jeanette Carlqvist
Ulf Nyman
Gunnar Sterner
John Brandberg
Erika Fagman
Mikael Hellström
Author Affiliation
Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Source
Eur Radiol. 2021 May; 31(5):3248-3257
Date
May-2021
Language
English
Publication Type
Journal Article
Keywords
Acute Kidney Injury - chemically induced - epidemiology
Aged
Contrast Media - adverse effects
Creatinine
Female
Glomerular Filtration Rate
Humans
Kidney
Male
Middle Aged
Prospective Studies
Retrospective Studies
Risk factors
Sweden
Abstract
Previous large studies of contrast-induced or post-contrast acute kidney injury (CI-AKI/PC-AKI) have been observational, and mostly retrospective, often with patients undergoing non-enhanced CT as controls. This carries risk of inclusion bias that makes the true incidence of PC-AKI hard to interpret. Our aim was to determine the incidence of PC-AKI in a large, randomly selected cohort, comparing the serum creatinine (Scr) changes after contrast medium exposure with the normal intraindividual fluctuation in Scr.
In this prospective study of 1009 participants (age 50-65 years, 48% females) in the Swedish CArdioPulmonary bioImage Study (SCAPIS), with estimated glomerular filtration rate (eGFR) =?50 mL/min, all received standard dose intravenous iohexol at coronary CT angiography (CCTA). Two separate pre-CCTA Scr samples and a follow-up sample 2-4 days post-CCTA were obtained. Change in Scr was statistically analyzed and stratification was used in the search of possible risk factors.
Median increase of Scr post-CCTA was 0-2 µmol/L. PC-AKI was observed in 12/1009 individuals (1.2%) according to the old ESUR criteria (>?25% or >?44 µmol/L Scr increase) and 2 individuals (0.2%) when using the updated ESUR criteria (=?50% or = 27 µmol/L Scr increase). Possible risk factors (e.g., diabetes, age, eGFR, NSAID use) did not show increased risk of developing PC-AKI. The mean effect of contrast media on Scr did not exceed the intraindividual Scr fluctuation.
Iohexol administration to a randomly selected cohort with mildly reduced eGFR is safe, and PC-AKI is very rare, occurring in only 0.2% when applying the updated ESUR criteria.
• Iohexol administration to a randomly selected cohort, 50-65 years old with mildly reduced eGFR, is safe and PC-AKI is very rare. • Applying the updated ESUR PC-AKI criteria resulted in fewer cases, 0.2% compared to 1.2% using the old ESUR criteria in this cohort with predominantly mild reduction of renal function. • The mean effect of CM on Scr did not exceed the intraindividual background fluctuation of Scr, regardless of potential risk factors, such as diabetes or NSAID use in our cohort of 1009 individuals.
PubMed ID
33155105 View in PubMed
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Nurse radiographers' experiences of communication with patients who do not speak the native language.

https://arctichealth.org/en/permalink/ahliterature99398
Source
J Adv Nurs. 2010 Apr;66(4):774-83
Publication Type
Article
Date
Apr-2010
Author
Nabi Fatahi
Bengt Mattsson
Solveig M Lundgren
Mikael Hellström
Author Affiliation
Department of Radiology, Sahlgrenska University Hospital and The Sahlgrenska Academy at Gothenburg University, Sweden. nabi.fatahi@allmed.gu.se
Source
J Adv Nurs. 2010 Apr;66(4):774-83
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Adult
Communication Barriers
Female
Focus Groups
Humans
Language
Male
Middle Aged
Nurse Practitioners - psychology
Nurse-Patient Relations
Radiography - psychology
Sweden
Abstract
AIM: This paper is a report of a study exploring nurse radiographers' experiences of examining patients who do not speak the native language. BACKGROUND: The increased number of immigrant patients in Western countries poses a challenge to healthcare staff, as mutual understanding is needed in encounters with patients who do not speak the language of the host country. In particular, little is known about the quality of communication in the setting of radiological examinations, i.e. short encounters with demanding technical and caring components. METHODS: Three focus group interviews with experienced nurse radiographers (n = 11) were carried out in 2007. The interviews were audiotaped and transcribed. A qualitative content analysis method was applied to analyse the interview texts. FINDINGS: Four main categories emerged in the analysis: modes, needs, quality and improvements of interpreting. The need for an interpreter is strongly associated with the type of examination. For interventional procedures and contrast-enhanced examinations, a professional interpreter is required to inform the patient and to identify and handle side effects and complications. Friends, relatives, particularly children, and staff as interpreters were not considered ideal as an alternative. Shortage of time and lack of specific knowledge about radiological procedures were identified as problems with professional interpreters. Interpreter training and checklists specific for radiology department routines were suggested, as well as improved nurse radiographers' education on intercultural communication. CONCLUSION: The need for an interpreter, and the native tongue of the patient, should be clearly stated on the radiology request form, to allow timely scheduling of an interpreter. Intercultural communication in nurse radiographers' education should be enhanced.
PubMed ID
20423365 View in PubMed
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Patient-reported impacts of a conservative management programme for the clinically inapparent adrenal mass.

https://arctichealth.org/en/permalink/ahliterature117942
Source
Endocrine. 2013 Aug;44(1):228-36
Publication Type
Article
Date
Aug-2013
Author
Andreas Muth
Charles Taft
Lilian Hammarstedt
Lena Björneld
Mikael Hellström
Bo Wängberg
Author Affiliation
Department of Surgery, Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, SE-413 45, Gothenburg, Sweden. andreas.muth@vgregion.se
Source
Endocrine. 2013 Aug;44(1):228-36
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adrenal Gland Neoplasms - diagnosis - epidemiology - pathology - therapy
Adrenalectomy - statistics & numerical data
Adult
Aged
Aged, 80 and over
Antineoplastic Agents - therapeutic use
Cohort Studies
Female
Humans
Incidental Findings
Male
Middle Aged
Questionnaires
Self Report
Sweden - epidemiology
Tumor Burden
Abstract
The aim of this study was to assess patient-reported impacts and health-related quality of life (HRQL) of a 2-year follow-up programme in a large cohort of patients with stationary, non-functioning, adrenal incidentalomas (AIs) in western Sweden. 145 patients (mean age 68 years, 62 % females) with AI from a prospective study in western Sweden were studied. All had completed a 2-year follow-up programme by November 2007, without evidence of adrenal malignancy or hormone over-production. To evaluate patient-reported impacts and HRQL, an eight-item adrenal incidentaloma impact questionnaire was used retrospectively, together with the hospital anxiety and depression scale, and the short form-36. There were 111 patients (mean age 67 years, 63 % females) who responded to the questionnaire (response rate 77 %). 77 % reported that the AI diagnosis had caused them to be worried; however, fewer than 20 % had thought about the lesion often during the follow-up programme, and only 3 % had felt that it had a large impact on their current daily life. Only 4 % stated that the follow-up programme had been a negative experience, nevertheless 10 % reported a negative impact on their HRQL during the follow-up programme. Only 2 % stated that release from follow-up caused worry to any degree. In total, 29 % had possible anxiety, and 30 % had possible depression, probably reflecting significant co-morbidity. Possible anxiety correlated with a more negative experience of the follow-up programme. In conclusion, the 2-year follow-up programme for patients with AI was well tolerated. Nonetheless, a small number remained worried throughout follow-up, suggesting the need for tailored counselling in individual patients to ameliorate negative impacts of follow-up.
Notes
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PubMed ID
23250632 View in PubMed
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Performance and inter-observer variability of prostate MRI (PI-RADS version 2) outside high-volume centres.

https://arctichealth.org/en/permalink/ahliterature308455
Source
Scand J Urol. 2019 Oct; 53(5):304-311
Publication Type
Journal Article
Date
Oct-2019
Author
Kimia Kohestani
Jonas Wallström
Niclas Dehlfors
Ole Martin Sponga
Marianne Månsson
Andreas Josefsson
Sigrid Carlsson
Mikael Hellström
Jonas Hugosson
Author Affiliation
Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Source
Scand J Urol. 2019 Oct; 53(5):304-311
Date
Oct-2019
Language
English
Publication Type
Journal Article
Keywords
Aged
Hospitals, Private
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Observer Variation
Prostate - diagnostic imaging
Prostatectomy - methods
Prostatic Neoplasms - diagnostic imaging - pathology - surgery
Retrospective Studies
Sensitivity and specificity
Sweden
Abstract
Objective: Despite the growing trend to embrace pre-biopsy MRI in the diagnostic pathway for prostate cancer (PC), its performance and inter-observer variability outside high-volume centres remains unknown. This study aims to evaluate sensitivity of and variability between readers of prostate MRI outside specialized units with radical prostatectomy (RP) specimen as the reference standard.Materials and methods: Retrospective study comprising a consecutive cohort of all 97 men who underwent MRI and subsequent RP between January 2012 and December 2014 at a private hospital in Sweden. Three readers, blinded to clinical data, reviewed all images (including 11 extra prostate MRI to reduce bias). A tumour was considered detected if the overall PI-RADS v2 score was 3-5 and there was an approximate match (same or neighbouring sector) of tumour sector according to a 24 sector system used for both MRI and whole mount sections.Results: Detection rate for the index tumour ranged from 67 to 76%, if PI-RADS 3-5 lesions were considered positive and 54-66% if only PI-RADS score 4-5 tumours were included. Detection rate for aggressive tumours (GS = 4?+?3) was higher; 83.1% for PI-RADS 3-5 and 79.2% for PI-RADS 4-5. The agreement between readers showed average [Formula: see text] values of 0.41 for PI-RADS score 3-5 and 0.51 for PI-RADS score 4-5.Conclusions: Prostate MRI evidenced a moderate detection rate for clinically significant PC with a rather large variability between readers. Clinics outside specialized units must have knowledge of their performance of prostate MRI before considering omitting biopsies in men with negative MRI.
PubMed ID
31661357 View in PubMed
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Serum anti-Müllerian hormone and ovarian morphology assessed by magnetic resonance imaging in response to acupuncture and exercise in women with polycystic ovary syndrome: secondary analyses of a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature261763
Source
Acta Obstet Gynecol Scand. 2015 Mar;94(3):279-87
Publication Type
Article
Date
Mar-2015
Author
Henrik Leonhardt
Mikael Hellström
Berit Gull
Anna-Karin Lind
Lars Nilsson
Per Olof Janson
Elisabet Stener-Victorin
Source
Acta Obstet Gynecol Scand. 2015 Mar;94(3):279-87
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Acupuncture Therapy - methods
Adult
Anti-Mullerian Hormone - blood
Exercise Therapy - methods
Female
Humans
Magnetic Resonance Imaging
Polycystic Ovary Syndrome - blood - pathology - therapy
Sweden
Women's health
Young Adult
Abstract
To investigate whether electro-acupuncture or physical exercise influence serum anti-Müllerian hormone (AMH), antral follicle count (AFC) or ovarian volume in women with polycystic ovary syndrome (PCOS).
Secondary analyses of a prospective, randomized controlled clinical trial.
University Hospital, Sweden.
Seventy-four women with PCOS recruited from the general population.
Women with PCOS were randomized to 16 weeks of electro-acupuncture (14 treatments), exercise (at least three times/week), or no intervention.
Serum AMH recorded at baseline, after 16 weeks of intervention, and at follow up at 32 weeks. AFC, and ovarian volume assessed by magnetic resonance imaging at baseline and at follow up at 32 weeks.
After 16 weeks of intervention, serum levels of AMH were significantly decreased in the electro-acupuncture group by 17.5% (p
PubMed ID
25545309 View in PubMed
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Survey update on implementation, indications, and technical performance of computed tomography colonography in Sweden.

https://arctichealth.org/en/permalink/ahliterature146948
Source
Acta Radiol. 2010 Feb;51(1):4-8
Publication Type
Article
Date
Feb-2010
Author
Valeria A Fisichella
Mikael Hellström
Author Affiliation
Department of Radiology, Sahlgrenska University Hospital and Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. valeria.fisichella@vgregion.se
Source
Acta Radiol. 2010 Feb;51(1):4-8
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Colonography, Computed Tomographic - statistics & numerical data - utilization
Humans
Physician's Practice Patterns - statistics & numerical data
Questionnaires
Sweden
Abstract
Computed tomographic colonography (CTC) has gained increased acceptance in the last few years as a valid substitute for double-contrast barium enema (DCBE). However, implementation of new technologies is complex, since several factors may influence the process.
To evaluate the current situation in Sweden concerning implementation of CTC, as compared to a previous national survey in 2005.
In December 2008, a structured, self-assessed questionnaire regarding implementation and technical performance of CTC was mailed to all radiology departments in Sweden. In March 2009, departments who had not replied were contacted by e-mail or by telephone. All (100%, 119/119) departments answered the questionnaire.
CTC is currently performed in 50/119 (42%) departments, i.e., 18 additional departments compared to 2005. Twenty-three out of 60 (38%) responding departments stated that they intend to start to perform CTC in the near future. DCBE is currently performed in 77/119 (65%) departments, 12 departments less compared to 2005. The most common reasons for non-implementation of CTC are non-availability of spiral CT scanner (41%, 26/64) and/or multidetector-row CT scanner (39%, 25/64), and lack of doctors' time (34%, 22/64). Only 3% (2/64) of departments are "awaiting further scientific documentation" on CTC, a significant reduction compared to 2005 (P=0.002). Until 2009, 59% (29/49) of CTC centers had performed more than 200 CTCs compared to 13% (4/32) of CTC centers in 2005. Intravenous contrast material is routinely administered in 86% (42/49), and carbon dioxide is used to distend the colon in 90% (44/49). Almost all radiology departments (93%, 93/100) currently believe that CTC will "absolutely" or "probably" replace barium enema in the future, while in 2005 only 56% (55/99) gave similar answers.
The survey reflects a further transition process from DCBE to CTC, with attitudes of radiologists increasingly in favor of CTC, although DCBE is still performed by the majority of radiology departments. DCBE should be replaced by colonoscopy and CTC, but the transition requires both human and economic resources.
Notes
Comment In: Acta Radiol. 2010 Jul;51(6):70820438291
PubMed ID
19961399 View in PubMed
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Swedish Cancer Society radiation therapy research investigation.

https://arctichealth.org/en/permalink/ahliterature18063
Source
Acta Oncol. 2002;41(7-8):596-603
Publication Type
Article
Date
2002
Author
Sören Mattsson
Anders Brahme
Jörgen Carlsson
Juliana Denekamp
Eva Forssell-Aronsson
Mikael Hellström
Karl-Axel Johansson
Elisabeth Kjellén
Bo Littbrand
Bo Nordenskjöld
Bo Stenerlöw
Ingela Turesson
Björn Zackrisson
Bengt Glimelius
Author Affiliation
Department of Radiation Physics, Malmö University Hospital, Malmö, Sweden.
Source
Acta Oncol. 2002;41(7-8):596-603
Date
2002
Language
English
Publication Type
Article
Keywords
Humans
Neoplasms - radiotherapy
Research
Societies, Medical
Sweden
Abstract
In an investigation by the Swedish Cancer Society, the present status, critical issues and future aspects and prospects were described by an expert group for each of nine major areas of radiation research. A summary of the investigation is presented in this report. A more extensive summary (in Swedish) can be found at www.Cancerfonden.se. It is concluded that radiation therapy plays an increasingly important role in curative and palliative tumour treatment and presents a considerable challenge to research. Several suggestions are made that could improve the possibilities for high-quality radiation therapy research in Sweden.
PubMed ID
14651202 View in PubMed
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11 records – page 1 of 2.