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[An analysis of the demand of endoscopic ultrasonography in Denmark]

https://arctichealth.org/en/permalink/ahliterature19028
Source
Ugeskr Laeger. 2002 Jun 17;164(25):3337-40
Publication Type
Article
Date
Jun-17-2002
Author
Alan Patrick Ainsworth
Per Michael Bau Mortensen
Author Affiliation
Organkirurgisk afdeling, Vejle Sygehus, DK-7100 Vejle. alan.ainsworth@dadlnet.dk
Source
Ugeskr Laeger. 2002 Jun 17;164(25):3337-40
Date
Jun-17-2002
Language
Danish
Publication Type
Article
Keywords
Denmark
Endoscopy, Gastrointestinal - utilization
Endosonography - utilization
English Abstract
Gastrointestinal Diseases - ultrasonography
Gastrointestinal Neoplasms - ultrasonography
Health Care Surveys
Health Services Needs and Demand - statistics & numerical data
Humans
Physician's Practice Patterns - statistics & numerical data
Questionnaires
Referral and Consultation - statistics & numerical data
Abstract
INTRODUCTION: Endoscopic ultrasonography (EUS) has been available in Denmark for about 10 years. Capacity problems can occur, because only a few departments perform this procedure. The aim of the present study was to analyse the demand for EUS in Denmark. METHODS: Questionnaires (140) were sent out to departments in Denmark, which were presumed to refer patients for EUS on a regular basis. RESULTS: One-hundred and seventeen questionnaires (84%) were returned. Twenty-three (20%) of the departments that returned the questionnaire stated that they never referred patients for EUS. The main reason was that patients, for whom EUS was considered necessary, were rarely treated in these departments (15 departments). Seventy departments (74%) referred 0-2 patients for EUS monthly. Twenty-one departments (22%) had problems in obtaining the number of investigations needed. There were significantly fewer problems in obtaining the desired number of investigations, if EUS was performed in the home county (p = 0.012). Thirty-eight per cent of the departments stated that more patients would be referred for EUS, if the procedure became more available in the future. DISCUSSION: There seems to be too small a capacity for EUS in Denmark. Whether the capacity should be increased by establishing new centres or by extending the present ones is unknown. Both solutions have benefits and drawbacks.
Notes
Comment In: Ugeskr Laeger. 2002 Jun 17;164(25):332512107943
PubMed ID
12107947 View in PubMed
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[Application of endoscopic investigation in diagnosis of duodenal major papilla cancer]

https://arctichealth.org/en/permalink/ahliterature17283
Source
Klin Khir. 2004 Oct;(10):5-7
Publication Type
Article
Date
Oct-2004
Author
V F Saienko
V M Kopchak
V M Cherniev
K V Kopchak
V A Zosym
K D Tkach
Ia V Romaniv
Source
Klin Khir. 2004 Oct;(10):5-7
Date
Oct-2004
Language
Ukrainian
Publication Type
Article
Keywords
Aged
Ampulla of Vater - surgery - ultrasonography
Common Bile Duct Neoplasms - surgery - ultrasonography
Endosonography
English Abstract
Female
Humans
Male
Middle Aged
Severity of Illness Index
Abstract
Endoscopic ultrasonographic investigation (EUSI) was performed in 12 patients with duodenal major papilla cancer, to whom the performance of radical surgical intervention was planned. In 9 patients the diagnosis, according to the EUSI data, was confirmed, in 1--cancer of pancreatic head was diagnosed, in 1--adenoma of duodenal major papilla, in 1--false-negative result was obtained Results of investigation was confirmed intraoperatively and according to the histological investigation data. Application of EUSI have permitted to determine correctly before the operation the stage of the disease in 8 of 9 patients. The method may be applied for verification of the diagnosis in patients with cancer of duodenal major papilla
PubMed ID
15628228 View in PubMed
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Assessing outcomes following surgery for colorectal cancer using quality of care indicators.

https://arctichealth.org/en/permalink/ahliterature142037
Source
Can J Surg. 2010 Aug;53(4):232-40
Publication Type
Article
Date
Aug-2010
Author
Omar Vergara-Fernandez
Carol J Swallow
J Charles Victor
Brenda I O'Connor
Robert Gryphe
Helen M MacRae
Zane Cohen
Robin S McLeod
Author Affiliation
Zane Cohen Centre for Digestive Diseases, Department of Surgery, Mount Sinai Hospital, Toronto, Ont., Canada.
Source
Can J Surg. 2010 Aug;53(4):232-40
Date
Aug-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Colectomy - standards
Colonoscopy
Colorectal Neoplasms - diagnosis - surgery
Endosonography
Feasibility Studies
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Ontario
Outcome Assessment (Health Care) - methods
Postoperative Period
Prospective Studies
Quality Indicators, Health Care
Tomography, X-Ray Computed
Young Adult
Abstract
We sought to assess the feasibility of applying Cancer Care Ontario's quality of care indicators to a single institution's colorectal cancer (CRC) database. We also sought to assess their utility in identifying areas that require improvement.
We included patients who had surgery for CRC between 1997 and 2006 at Mount Sinai Hospital, Toronto, Ont. We excluded patients who had transanal excisions, carcinoma in situ or recurrences that required pelvic exenteration, as well as those whose information was incomplete. We obtained data from a prospective database and verified the data with hospital and office charts. We evaluated trends over a 10-year period using the Cochran-Armitage trend test.
During the study period there were 1005 surgical procedures performed in 987 patients with a mean age of 65.6 (standard deviation 15) years; the male:female ratio was 1:2. The most frequent tumour sites were the rectum and sigmoid colon (68%). Over the 10-year period, 9 indicators improved, including the proportion of patients with CRC identified by screening (p
Notes
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PubMed ID
20646396 View in PubMed
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Can Power Doppler enhanced transrectal ultrasound guided biopsy improve prostate cancer detection on first and repeat prostate biopsy?

https://arctichealth.org/en/permalink/ahliterature17505
Source
Eur Urol. 2004 Oct;46(4):451-6
Publication Type
Article
Date
Oct-2004
Author
Mesut Remzi
Michael Dobrovits
Andreas Reissigl
Vincent Ravery
Mattias Waldert
Christian Wiunig
Yan Kit Fong
Bob Djavan
Author Affiliation
Department of Urology, University of Vienna, Währinger Gürtel 18-20, Austria. mremzi@gmx.at
Source
Eur Urol. 2004 Oct;46(4):451-6
Date
Oct-2004
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - pathology - ultrasonography
Aged
Aged, 80 and over
Biopsy - statistics & numerical data
Endosonography - methods
Humans
Male
Middle Aged
Predictive value of tests
Prostate-Specific Antigen - analysis
Prostatic Neoplasms - pathology - ultrasonography
Rectum
Ultrasonography, Doppler, Color
Abstract
OBJECTIVE: To determine the utility of Power Doppler enhanced transrectal ultrasound (PD-TRUS) and its guided prostate biopsies in men with prostate specific antigen (PSA) levels between 2.5 and 10 ng/ml and to evaluate its impact on prostate cancer (PCa) detection in men undergoing first and repeat biopsies. METHODS: A total of 136 consecutive referred men with serum total PSA (Abbott Laboratories, Abbott Park, IL, USA) levels between 2.5 and 10 ng/ml (mean age 64 +/- 9 years, range 45-82) and a normal digital rectal examination were included. 101 underwent a first biopsy whereas 35 had repeat biopsy. Gray-scale transrectal ultrasound (TRUS), and PD-TRUS (B&K Medical, Denmark) were performed in lithotomy position before and during the biopsy procedure. Vascularity accumulation and perfusion characteristics were recorded and graded as normal or abnormal in the peripheral zone of the prostate. A Vienna-nomogram based biopsy regime was performed in all patients on first biopsy and a special biopsy regime on repeat biopsy plus additional biopsies from abnormal sites on PD-TRUS. RESULTS: Overall PCa detection rate was 34.7% and 25.7% and abnormal accumulation on PD-TRUS was identified in 42.3% and 48.6% on first and repeat biopsy, respectively. The PCa detection rate, on first and repeat biopsy in patients with and without PD-TRUS accumulation were 67.4% versus 10.3% (p
PubMed ID
15363559 View in PubMed
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Carotid plaque echogenicity and risk of nonvertebral fractures in women: a longitudinal population-based study.

https://arctichealth.org/en/permalink/ahliterature80187
Source
Calcif Tissue Int. 2006 Oct;79(4):207-13
Publication Type
Article
Date
Oct-2006
Author
Jørgensen L.
Joakimsen O.
Mathiesen E B
Ahmed L.
Berntsen G K R
Fønnebø V.
Joakimsen R.
Njølstad I.
Schirmer H.
Jacobsen B K
Author Affiliation
Institute of Community Medicine, University of Tromsø, Breivika, N-9037, Tromsø, Norway. lone.jorgensen@ism.uit.no
Source
Calcif Tissue Int. 2006 Oct;79(4):207-13
Date
Oct-2006
Language
English
Publication Type
Article
Keywords
Aged
Carotid Stenosis - ultrasonography
Endosonography
Female
Fractures, Bone - epidemiology
Humans
Longitudinal Studies
Middle Aged
Risk factors
Spine
Abstract
Atherosclerosis and osteoporosis appear to be related, but prospective studies on the relationship are sparse. In order to examine whether carotid artery plaques with different morphology predict nonvertebral fractures, we followed 2,733 women, aged 55-74 years (75% of the eligible population in Troms?, Norway), for 6 years. At baseline, plaque morphology in terms of ultrasound echogenicity was categorized into three groups, ranging from low echogenicity (echolucent plaques with a high content of soft tissue) to strong echogenicity (echogenic plaques with a high content of dense fibrous tissue and calcified material). We found that the age-adjusted relative risk (RR) of fracture was significantly higher among women with echogenic plaques than among women without plaques: 1.7 (95% confidence interval [CI] 1.0-2.7). After adjustment for bone mineral density at baseline in addition to age, the RR was 1.6 (95% CI 1.0-2.6), and further adjustments for body mass index, body height, high-density lipoprotein cholesterol, smoking status, and muscle strength did not influence the association. Subjects with other plaque types were not at an increased risk compared to subjects without plaques: RR
PubMed ID
17048067 View in PubMed
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The clinical impact and cost implication of endoscopic ultrasound on use of endoscopic retrograde cholangiopancreatography in a Canadian university hospital.

https://arctichealth.org/en/permalink/ahliterature158620
Source
Can J Gastroenterol. 2008 Feb;22(2):138-42
Publication Type
Article
Date
Feb-2008
Author
N. Alhayaf
E. Lalor
V. Bain
J. McKaigney
G Singh Sandha
Author Affiliation
Department of Internal Medicine, University of Alberta Hospital, Edmonton, Canada.
Source
Can J Gastroenterol. 2008 Feb;22(2):138-42
Date
Feb-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Canada
Cholangiopancreatography, Endoscopic Retrograde - economics - utilization
Choledocholithiasis - radiography - therapy - ultrasonography
Cost-Benefit Analysis
Endosonography - economics
Female
Health Care Costs
Hospitalization - economics
Hospitals, University
Humans
Male
Middle Aged
Referral and Consultation
Retrospective Studies
Abstract
Endoscopic ultrasound (EUS) is a safe alternative to endoscopic retrograde cholangiopancreatography (ERCP) for diagnostic biliary imaging in choledocholithiasis. Evidence linking a decline in diagnostic ERCP with the introduction of EUS in clinical practice is limited.
To assess the clinical impact and cost implications of a new EUS program on diagnostic ERCP at a tertiary referral centre.
A retrospective review was performed of data collected during the first year of EUS at the University of Alberta Hospital (Edmonton, Alberta). Patients were referred for ERCP because of suspicion of choledocholithiasis based on clinical, biochemical and/or radiological parameters. If they were assessed to have an intermediate probability of choledocholithiasis, EUS was performed first. ERCP was performed if EUS suggested choledocholithiasis, whereas patients were clinically followed for six months if their EUS was normal. Cost data were assessed from a third-party payer perspective, and cost savings were expressed in terms of ERCP procedures avoided.
Over 12 months, 90 patients (63 female, mean age 58 years) underwent EUS for suspected biliary tract abnormalities. EUS suggested choledocholithiasis in 20 patients (22%), and this was confirmed by ERCP in 17 of the 20 patients. EUS was normal in 69 patients, and none underwent a subsequent ERCP during a six-month follow-up period. One patient had pancreatic cancer and did not undergo ERCP. The sensitivity and specificity of EUS for choledocholithiasis were 100% and 96%, respectively. A total of 440 ERCP procedures were performed over the same 12-month period, suggesting that EUS resulted in a 14% reduction in ERCP procedures (70 of 510). There were no complications of EUS. The cost of 90 EUS procedures was $42,840, compared with $108,854 for 70 ERCP procedures. The cost savings for the first year were $66,014.
EUS appears to be accurate, safe and cost effective in diagnostic biliary imaging for suspected choledocholithiasis. The impact of EUS is the avoidance of ERCP in selected cases, thereby preventing the risk of complications. Diagnostic ERCP should not be performed in centres and regions with physicians trained in EUS.
Notes
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PubMed ID
18299731 View in PubMed
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Clinical impact of endoscopic ultrasonography at a county hospital.

https://arctichealth.org/en/permalink/ahliterature19108
Source
Endoscopy. 2002 Jun;34(6):447-50
Publication Type
Article
Date
Jun-2002
Author
A P Ainsworth
M B Mortensen
J. Durup
P A Wamberg
Author Affiliation
Dept. of Surgery, Vejle Hospital, Vejle, Denmark. alan.ainsworth@dadlnet.dk
Source
Endoscopy. 2002 Jun;34(6):447-50
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Denmark
Endosonography - utilization
Female
Hospitals, County
Humans
Male
Middle Aged
Predictive value of tests
Sensitivity and specificity
Abstract
BACKGROUND AND STUDY AIMS: Although endoscopic ultrasonography (EUS) is a well-described examination method, there have been few reports concerning its clinical impact. The aim of this study was to describe EUS as it is performed at a county hospital, with an emphasis on the indications and clinical outcome. PATIENTS AND METHODS: Patients examined using EUS between December 1997 and November 2000 were recorded prospectively. Follow-up was conducted by examining each patient's medical records at least 3 months after the investigation. The EUS findings were compared with the patient's final diagnosis, and the decisions made by the referring department on the basis of each investigation were recorded. RESULTS: A total of 344 EUS procedures were performed. In the third year, the distribution of patients relative to the various referral diagnoses was: 78 with suspected benign pancreaticobiliary disease, 33 for staging of known upper gastrointestinal tract malignancy, 15 with suspected mediastinal disease or for staging of lung cancer, 13 with suspected submucosal lesions, and five with unclassified disease. Follow-up was possible in 340 patients (99 %). Compared to the final diagnosis in each patient, the sensitivity, specificity, and accuracy rates of EUS were 86 %, 90 %, and 88 %, respectively. The EUS findings made more invasive procedures unnecessary in 199 patients (58 %). EUS led to a switch to less invasive procedures in 61 patients (18 %), and it had no influence on the further management strategy in 80 patients (24 %). CONCLUSIONS: EUS has a high level of accuracy and a substantial clinical impact when performed in an unselected population. The estimated numbers of investigations needed appear to justify setting up an EUS center at institutions with a catchment population of 350 000 inhabitants.
Notes
Comment In: Endoscopy. 2002 Jun;34(6):492-412048635
PubMed ID
12048625 View in PubMed
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Clinicians' attitudes towards endoscopic ultrasound: a survey of four European countries.

https://arctichealth.org/en/permalink/ahliterature91370
Source
Scand J Gastroenterol. 2009;44(1):100-7
Publication Type
Article
Date
2009
Author
Kalaitzakis Evangelos
Panos Marios
Sadik Riadh
Aabakken Lars
Koumi Andriani
Meenan John
Author Affiliation
Department of Gastroenterology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. evangelos.kalaitzakis@vgregion.se
Source
Scand J Gastroenterol. 2009;44(1):100-7
Date
2009
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Biliary Tract Diseases - ultrasonography
Digestive System Diseases - economics - ultrasonography
Endosonography - economics - utilization
Esophageal Neoplasms - ultrasonography
Great Britain
Greece
Health Care Surveys
Humans
Logistic Models
Norway
Pancreatic Diseases - ultrasonography
Physician's Practice Patterns
Questionnaires
Rectal Neoplasms - ultrasonography
Sweden
Abstract
OBJECTIVE: Despite the documented effectiveness of endoscopic ultrasound (EUS) in research studies, data on the utilization of this technology in clinical practice are scarce. The aim of this study was to assess EUS availability and accessibility as well as EUS utilization among clinicians from different European countries. MATERIAL AND METHODS: A direct mail survey was sent to members of the national gastroenterological associations in Sweden, Norway, Greece, and the United Kingdom. RESULTS: Out of 2361 clinicians with valid addresses, 593 (25.1%) responded. Overall, EUS was available to 43% of clinicians within their practice but availability varied from 23% in Greece to 56% in the United Kingdom. More than 50% of respondents evaluating patients with esophageal cancer, rectal cancer, or pancreaticobiliary disorders had utilized EUS during the previous year, but utilization varied considerably among different countries, being more frequent in the United Kingdom. In logistic regression analyses, factors independently related to EUS utilization were mainly EUS availability and accessibility as well as perceived utility of EUS (p
PubMed ID
18985538 View in PubMed
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Endobronchial ultrasound-guided transbronchial needle aspiration in the management of previously treated lung cancer.

https://arctichealth.org/en/permalink/ahliterature134390
Source
Ann Thorac Surg. 2011 Jul;92(1):251-5; discussion 255
Publication Type
Article
Date
Jul-2011
Author
Masaki Anraku
Andrew F Pierre
Takahiro Nakajima
Marc de Perrot
Gail E Darling
Thomas K Waddell
Shaf Keshavjee
Kazuhiro Yasufuku
Author Affiliation
Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Source
Ann Thorac Surg. 2011 Jul;92(1):251-5; discussion 255
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Biopsy, Fine-Needle - methods
Cohort Studies
Endosonography - methods
Female
Follow-Up Studies
Hospitals, University
Humans
Immunohistochemistry
Lung Neoplasms - pathology - surgery
Lymph Nodes - pathology
Male
Mediastinal Neoplasms - pathology - secondary - ultrasonography
Middle Aged
Monitoring, Physiologic - methods
Neoplasm Invasiveness - pathology
Ontario
Pneumonectomy - adverse effects - methods
Retrospective Studies
Risk assessment
Young Adult
Abstract
This study evaluated the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the assessment of newly developed mediastinal/hilar abnormalities in patients with previously treated lung cancer.
All EBUS-TBNA cases between July 2008 and October 2010 were retrospectively reviewed. Results of EBUS-TBNA in previously treated lung cancer patients were analyzed. Cancer treatments, numbers of stations biopsied, and pathologic results were recorded. Nonmalignant cytopathology was confirmed with clinical follow-up for benign results.
Of 450 patients who underwent EBUS-TBNA, 44 (9.8%) had previous lung cancer treatment, comprising non-small cell lung cancer in 40, small-cell lung cancer in 3, and typical carcinoid in 1. No EBUS-TBNA was performed for lung cancer restaging. Primary treatments included surgical resection in 22, resection with adjuvant/neoadjuvant therapy in 11, chemoradiation in 5, chemotherapy in 4, and radiotherapy in 2. At the primary treatment, 23 of 44 patients had mediastinoscopy. EBUS-TBNA of mediastinal lymph nodes was performed in 40. An average of 1.7 stations were biopsied (range, 1 to 5). The positive EBUS-TBNA in 28 included mediastinal/hilar recurrence of primary lung cancer (ie, same cell type as primary cancer) in 21, and possible new primary lung cancer (ie, different cell type from primary lung cancer) in 7. The sensitivity, specificity, and diagnostic accuracy were 93.1%, 100%, and 95.1%, respectively.
EBUS-TBNA can differentiate a new primary lung cancer from recurrence of previously treated lung cancer, which will facilitate treatment strategy.
PubMed ID
21592457 View in PubMed
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40 records – page 1 of 4.