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- Hansson, Jonny, et al.
(författare)
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An optimisation strategy in a digital environment applied to neonatal chest imaging.
- 2005
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Ingår i: Radiation protection dosimetry. - : Oxford University Press (OUP). - 0144-8420 .- 1742-3406. ; 114:1-3, s. 278-85
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to find the optimum tube voltage for neonatal chest imaging in computed radiography. The study was designed to take full advantage of the benefits of digital imaging, for example, by comparing the tube voltages at constant effective dose. A phantom study using a living rabbit was first conducted. Images were collected at tube voltages ranging from 40 to 90 kV(p). The reproduction of four structures (central vessels, peripheral vessels, carina and thoracic vertebrae) was rated by 10 radiologists. The reproduction of both central and peripheral vessels was relatively independent of tube voltage. The carina was better reproduced at higher tube voltages whereas the opposite was true for the thoracic vertebrae. Based on the higher importance of the reproduction of the carina it was decided that 90 kV(p) was the optimal tube voltage. To validate the result from the phantom study, a follow-up study was conducted in which images of neonates collected at the tube voltage regularly used at Sahlgrenska University Hospital (70 kV(p)) were compared with images collected at the tube voltage proposed by the phantom study. The follow-up study confirmed the results from the phantom study that the reproduction of the carina was better at 90 than at 70 kV(p). In conclusion, for neonatal chest imaging-given the same effective dose-90 kVp gives better reproduction of important structures than the regularly used 70 kV(p).
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| 3. |
- Olausson, Eva A, et al.
(författare)
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A Small Particle Size Diet Reduces Upper Gastrointestinal Symptoms in Patients With Diabetic Gastroparesis: A Randomized Controlled Trial
- 2014
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Ingår i: American Journal of Gastroenterology. - : Ovid Technologies (Wolters Kluwer Health). - 0002-9270. ; 109:3, s. 375-385
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Gastroparesis is a well-known complication to diabetes mellitus (DM). Dietary advice is considered to be of importance to reduce gastrointestinal (GI) symptoms in patients with diabetic gastroparesis, but no randomized controlled trials exist. Our aim was to compare GI symptoms in insulin treated DM subjects with gastroparesis eating a diet with small particle size ("intervention diet") with the recommended diet for DM ("control diet"). METHODS: 56 subjects with insulin treated DM and gastroparesis were randomized to the intervention diet or the control diet. The patients received dietary advice by a dietitian at 7 occasions during 20 weeks. GI symptom severity, nutrient intake and glycemic control were measured before and after the intervention. RESULTS: A significantly greater reduction of the severity of the key gastroparetic symptoms-nausea/vomiting (P=0.01), postprandial fullness (P=0.02) and bloating (P=0.006)-were seen in patients who received the intervention diet compared with the control diet, and this was also true for regurgitation/heartburn (P=0.02), but not for abdominal pain. Anxiety was reduced after the intervention diet, but not after the control diet, whereas no effect on depression or quality of life was noted in any of the groups. A higher fat intake in the intervention group was noted, but otherwise no differences in body weight, HbA1c or nutrient intake were seen. CONCLUSIONS: A small particle diet improves the key symptoms of gastroparesis in patients with diabetes mellitus. (ClinicalTrials.gov NCT01557296)
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| 4. |
- Olausson, Eva A, et al.
(författare)
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Measurement of gastric emptying by radiopaque markers in patients with diabetes: correlation with scintigraphy and upper gastrointestinal symptoms
- 2013
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Ingår i: Neurogastroenterology and Motility. - : Wiley. - 1350-1925. ; 25:3
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Tidskriftsartikel (refereegranskat)abstract
- Background Scintigraphy, the gold standard to measure gastric emptying, is expensive and not widely available. Therefore, we compared emptying of radiopaque markers (ROM) from the stomach, by use of fluoroscopy, with scintigraphy in patients with insulin-treated diabetes. Methods On the same day we measured gastric emptying of 20 ROM using fluoroscopy and scintigraphic emptying of a standard solid meal. The subjects also completed a validated gastrointestinal (GI) symptom questionnaire. Key Results We included 115 patients with insulin-treated diabetes (median age 53, range 21–69 years; 59 women). A moderately strong correlation was demonstrated between scintigraphic (% retained at 2 h) and ROM emptying (markers retained at 6 h) (r = 0.47; P < 0.0001). Eighty-three patients had delayed gastric emptying with scintigraphy, whereas only 29 patients had delayed emptying of ROM. Of the 29 patients with delayed emptying of ROM, 28 also had delayed scintigraphic emptying. The sensitivity and specificity of the ROM test was 34% and 97%, respectively. Significant correlations were only noted between scintigraphic gastric emptying and GI symptom severity, with the strongest correlations for fullness/early satiety (r = 0.34; P < 0.001) and nausea/vomiting (r = 0.30; P < 0.001). Conclusions & Inferences A gastric emptying test with ROM is a widely available screening method to detect delayed gastric emptying in patients with diabetes, where a positive result seems reliable. However, a normal ROM test does not exclude delayed gastric emptying, and if the clinical suspicion of gastroparesis remains, scintigraphy should be performed. Results from scintigraphy also correlate with GI symptom severity, which ROM test did not.
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| 5. |
- Olausson, Eva A, et al.
(författare)
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Postprandial Plasma Glucose Response and Gastrointestinal Symptom Severity in Patients With Diabetic Gastroparesis.
- 2014
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Ingår i: Journal of diabetes science and technology. - : SAGE Publications. - 1932-2968. ; 8:4, s. 881-888
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Tidskriftsartikel (refereegranskat)abstract
- Gastroparesis is a well-known diabetic complication. The pathogenesis is not fully understood. However, it is important to early diagnose these patients. This study evaluated the plasma glucose response after a test meal, and gastrointestinal (GI) symptom severity in patients with clinical suspicion of diabetic gastroparesis, and assessed its usefulness to predict gastroparesis. In all, 83 subjects with insulin-treated diabetes mellitus (DM) type 1 and 2 were included; 53 subjects had gastroparesis and 30 had normal gastric emptying determined by gastric scintigraphy. GI symptom severity during the preceding 2 weeks was evaluated with a validated questionnaire. The test meal consisted of 100 g meat, 40 g pasta, 150 g carrot, and 5 g oil. The subjects ingested the meal under fasting conditions, and plasma glucose was followed during 180 minutes. Patients with gastroparesis demonstrated a blunted plasma glucose response after a test meal versus patients with normal gastric emptying (P < .005), reflected by lower maximum increase in plasma glucose response and incremental area under the curve of the plasma glucose, but a similar time to the maximum plasma glucose level. All GI symptoms were more severe in patients with gastroparesis. GI symptom severity had the best discriminative value to identify patients with gastroparesis with an area under the receiver operating curve of 0.83 (optimal cutoff: sensitivity 87%, specificity 80%). Patients with diabetic gastroparesis have a blunted postprandial plasma glucose response. Combining this information with the presence of GI symptoms can help clinicians identify diabetic patients with gastroparesis.
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