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Search Results: 1 - 10 of 190862 matches for " Tr?g?rdh Elin "
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Nuclear medicine technologists are able to accurately determine when a myocardial perfusion rest study is necessary
Trgrdh Elin,Johansson Liselott,Olofsson Camilla,Valind Sven
BMC Medical Informatics and Decision Making , 2012, DOI: 10.1186/1472-6947-12-97
Abstract: Background In myocardial perfusion scintigraphy (MPS), typically a stress and a rest study is performed. If the stress study is considered normal, there is no need for a subsequent rest study. The aim of the study was to determine whether nuclear medicine technologists are able to assess the necessity of a rest study. Methods Gated MPS using a 2-day 99mTc protocol for 121 consecutive patients were studied. Visual interpretation by 3 physicians was used as gold standard for determining the need for a rest study based on the stress images. All nuclear medicine technologists performing MPS had to review 82 training cases of stress MPS images with comments regarding the need for rest studies, and thereafter a test consisting of 20 stress MPS images. After passing this test, the nuclear medicine technologists in charge of a stress MPS study assessed whether a rest study was needed or not or if he/she was uncertain and wanted to consult a physician. After that, the physician in charge interpreted the images and decided whether a rest study was required or not. Results The nuclear medicine technologists and the physicians in clinical routine agreed in 103 of the 107 cases (96%) for which the technologists felt certain regarding the need for a rest study. In the remaining 14 cases the technologists were uncertain, i.e. wanted to consult a physician. The agreement between the technologists and the physicians in clinical routine was very good, resulting in a kappa value of 0.92. There was no statistically significant difference in the evaluations made by technicians and physicians (P = 0.617). Conclusions The nuclear medicine technologists were able to accurately determine whether a rest study was necessary. There was very good agreement between nuclear medicine technologists and physicians in the assessment of the need for a rest study. If the technologists can make this decision, the effectiveness of the nuclear medicine department will improve.
Referring physicians underestimate the extent of abnormalities in final reports from myocardial perfusion imaging
Elin Trgrdh, Peter H?glund, Mattias Ohlsson, Mattias Wieloch, Lars Edenbrandt
EJNMMI Research , 2012, DOI: 10.1186/2191-219x-2-27
Abstract: After viewing final reports containing only typical clinical verbiage and images, physicians in nuclear medicine and referring physicians (physicians in cardiology, internal medicine, and general practitioners) independently classified 60 MPS tests for the presence versus absence of ischemia/infarction according to objective grades of 1–5 (1?=?No ischemia/infarction, 2?=?Probably no ischemia/infarction 3?=?Equivocal, 4?=?Probable ischemia/infarction, and 5?=?Certain ischemia/infarction). When ischemia and/or infarction were thought to be present in the left ventricle, all physicians were also asked to mark the involved segments based on the 17-segment model.There was good diagnostic agreement between physicians in nuclear medicine and referring physicians when assessing the general presence versus absence of both ischemia and infarction (median squared kappa coefficient of 0.92 for both). However, when using the 17-segment model, compared to the physicians in nuclear medicine, 12 of 23 referring physicians underestimated the extent of ischemic area while 6 underestimated and 1 overestimated the extent of infarcted area.Whereas referring physicians gain a good understanding of the general presence versus absence of ischemia and infarction from MPS test reports, they often underestimate the extent of any ischemic or infarcted areas. This may have adverse clinical consequences and thus the language in final reports from MPS tests might be further improved and standardized.Whenever diagnostic tests are performed, it is important that referring physicians fully understand the final report, written for example by other physicians who are most often radiologists or pathologists. If the message in the final report is not precisely understood, the patient might receive inadequate, inappropriate or potentially even harmful treatment. Numerous studies have investigated the sources for potential clinical errors in many different diagnostic methods, including technical aspects a
Small average differences in attenuation corrected images between men and women in myocardial perfusion scintigraphy: a novel normal stress database
Elin Trgrdh, Karl Sj?strand, David Jakobsson, Lars Edenbrandt
BMC Medical Imaging , 2011, DOI: 10.1186/1471-2342-11-18
Abstract: Normal stress perfusion databases were developed with data from 126 male and 205 female patients with normal MPS. The following comparisons were performed for all patients and separately for normal weight vs. obese patients: men vs. women for AC; men vs. women for NC; AC vs. NC for men; and AC vs. NC for women.When comparing AC for men vs. women, only minor differences in mean count values were observed, and there were no differences for normal weight vs. obese patients. For all other analyses major differences were found, particularly for the inferior wall.The results support the hypothesis that it is possible to use not only gender independent but also weight independent AC stress databases.Stress myocardial perfusion scintigraphy (MPS) is widely regarded as a clinically useful noninvasive imaging modality for diagnosing patients with suspected coronary artery disease [1-3]. However, Compton scatter and depth-dependent reduction of spatial resolution degrade MPS image quality and decrease test accuracy. In addition, localized soft-tissue attenuation by the breasts, lateral chest wall, and abdomen may create artefacts that mimic true perfusion abnormalities and decrease test specificity [4,5].Several studies have reported an increase in the diagnostic accuracy (through higher specificity) for the detection of coronary artery disease when MPS is attenuation corrected (AC) [6-12]. The American Society of Nuclear Cardiology and the Society of Nuclear Medicine conclude in their joint position statement from 2004 [6] that incorporation of AC in addition to ECG gating with MPS images will improve image quality, interpretive certainty, and diagnostic accuracy. These combined results are anticipated to have a substantial impact on improving the effectiveness of care and lowering health care costs. However, commonly used software packages for MPS usually only include a normal stress database for non-attenuation corrected (NC) images.The three most commonly used software pac
Widefield two-photon excitation without scanning: live cell microscopy with high time resolution and low photo-bleaching
Rumelo Amor,Johanna Trgrdh,Gillian Robb,Louise Wilson,Nor Zaihana Abdul Rahman,John Dempster,William Bradshaw Amos,Trevor J. Bushell,Gail McConnell
Physics , 2014,
Abstract: We demonstrate fluorescence imaging by two-photon excitation without scanning in biological specimens as previously described by Hwang and co-workers, but with an increased field size and with framing rates of up to 100 Hz. During recordings of synaptically-driven Ca$^{2+}$ events in primary rat neurone cultures loaded with the fluorescent Ca$^{2+}$ indicator Fluo-4 AM, we have observed greatly reduced photo-bleaching in comparison with single-photon excitation. This method, which requires no costly additions to the microscope, promises to be useful for work where high time-resolution is required.
Patient Experiences of Medical Screening Performed by the Dental Services: A Qualitative Study  [PDF]
G?ran Friman, Ghazaleh Golestani, Awara Kalkal, Inger W?rdh, Margareta Hultin
Open Journal of Stomatology (OJST) , 2013, DOI: 10.4236/ojst.2013.39081

Objective: To explore how medical screening performed by the dental service was perceived from the patient’s perspective. Material and methods: Medical screening for high blood pressure and high plasma glucose was performed on 170 patients at a dental clinic in a small town in central Sweden. Seventeen individual interviews were conducted with a strategic sampling of these patients. The interviews were recorded and transcribed. The transcriptions were coded and categorized in a manifest analysis, followed by a latent, interpretive analysis. Results: The manifest analysis resulted in three categories: Positive attitude to screening and dental professionals which need to have specific knowledge of medical screening; Dental care which provides continuity but is not a neutral environment; and Feedback on the medical screening results and desired cooperation between dental and health care services. The latent analysis pointed out the importance of the patient’s feeling that the procedure is carried out properly and safely, and requests for clear feedback concerning the results of the screening. Conclusions: The interviewees experienced the dental care service as providing continuity. They would like to have regular medical screenings at their regular dental appointments to identify risks of cardiovascular diseases and diabetes. However, they expressed that it was important for the dental care staff to have the necessary medical knowledge. They also wanted good cooperations between the dental and health care services, with clear feedback to the patients about both positive and negative results and, when appropriate, referrals to the health care service.

Explicit solutions of division problems for matrices of polynomials
Elin G?tmark
Mathematics , 2008,
Abstract: We present integral representations of solutions to division problems involving matrices of polynomials in several complex variables. We also find estimates of the polynomial degree of the solutions by means of careful degree estimates of the so-called Hefer forms which are components of the representations.
Weighted integral formulas on manifolds
Elin G?tmark
Mathematics , 2006, DOI: 10.1007/s11512-007-0056-7
Abstract: We present a method of finding weighted Koppelman formulas for $(p,q)$-forms on $n$-dimensional complex manifolds $X$ which admit a vector bundle of rank $n$ over $X \times X$, such that the diagonal of $X \times X$ has a defining section. We apply the method to $\Pn$ and find weighted Koppelman formulas for $(p,q)$-forms with values in a line bundle over $\Pn$. As an application, we look at the cohomology groups of $(p,q)$-forms over $\Pn$ with values in various line bundles, and find explicit solutions to the $\dbar$-equation in some of the trivial groups. We also look at cohomology groups of $(0,q)$-forms over $\Pn \times \Pm$ with values in various line bundles. Finally, we apply our method to developing weighted Koppelman formulas on Stein manifolds.
Boundary Behavior of Subelliptic Parabolic Equations on Time-Dependent Domains
Marie Frentz,Elin G?tmark
Mathematics , 2013,
Abstract: In this paper we study the boundary behavior of solutions of a divergence-form subelliptic heat equation in a time-varying domain \Omega in R^{n+1}, structured on a set of vector fields X = (X_1, ... X_m) with smooth coefficients satisfying H\"ormander's finite rank condition. Assuming that \Omega is an X-NTA domain, we first prove a Dahlberg type estimate comparing the X-caloric measure of \Omega and the Green function of the subelliptic heat operator. We then prove a backward Harnack inequality, the doubling property for the X-caloric measure of \Omega, the H\"older continuity at the boundary for quotients of solutions of H, and a Fatou theorem.
Explicit representation of membership in polynomial ideals
Mats Andersson,Elin G?tmark
Mathematics , 2008,
Abstract: We introduce a new division formula on projective space which provides explicit solutions to various polynomial division problems with sharp degree estimates. We consider simple examples as the classical Macaulay theorem as well as a quite recent result by Hickel, related to the effective Nullstellensatz. We also obtain a related result that generalizes Max Noether's classical AF+BG theorem.
Emergency Obstetric Care: Strategy for Reducing Maternal Mortality in Developing Countries
TR Bhandari,G Dangal
Nepal Journal of Obstetrics and Gynaecology , 2014, DOI: 10.3126/njog.v9i1.11179
Abstract: Twenty-five years have passed since the global community agreed in Nairobi to address the high maternal mortality by implementing the Safe Motherhood Initiative. However, every year nearly three million women die due to pregnancy related causes. This tragedy is avoidable if women have timely access to required emergency obstetric care.
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