The impact of digital techniques on radiological services

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenAll diagnostic imaging examinations may be performed digitally using computer techniques. The diagnostic reading in the imaging department can be made on a specialised computer screen and the images stored in a digital archive. The referring physician uses his computer to send requests and to read the reports. He can also access the images in the archive and view the images on a standard computer screen. The X-ray departments and their communication with referring physicians will be paper- and filmless, which results in considerable changes in working routines and increased speed of service. Digital X-ray techniques are described and some examples of digital services given.Með hjálp tölvutækni má framkvæma allar myndgreiningarrannsóknir þannig að myndirnar verði á stafrænu formi. Úrlestur rannsókna á röntgendeildum fer þá fram á sérhæfðum tölvuskjám og myndirnar eru geymdar í stafrænni myndgeymslu. Læknar sem vísa sjúklingi til rannsóknar senda beiðni og fá röntgensvör gegnum tölvunet. Tilvísandi læknir getur nálgast myndirnar í myndgeymslunni og skoðað þær á venjulegum tölvuskjá. Öll starfsemi röntgendeilda og samskipti við lækna verða í framtíðinni pappírs- og filmulaus. Þetta hefur veruleg áhrif, ekki einungis á starfsemi sjúkrahúsa, heldur munu sjúklingar heilsugæslulækna og sjálfstætt starfandi lækna njóta betri þjónustu. Raktar eru helstu aðferðir við að framkvæma hefðbundnar röntgenrannsóknir með stafrænni tækni sem og kostir stafrænna mynda. Þá er gerð grein fyrir ýmsum breytingum sem orðið geta á þjónustu röntgendeilda á Íslandi í náinni framtíð

Effects of controlled thawing media temperatures on quality and safety of pre-rigor frozen Atlantic cod (Gadus morhua)

Novel strategies for thawing of pre-rigor frozen Atlantic cod (Gadus morhua) in water with air circulation, applying different and controlled temperatures are presented. After thawing (day 0) and after six days of storage at 2.9 ± 0.6 °C (day 6), quality parameters (thawing- and drip loss, cooking yield, sensory evaluation, and textural properties), chemical (pH, water content, total volatile basic nitrogen (TVB-N)) and microbiological analyses (total viable counts (TVC-IA), H2S-producing bacteria (H2S-IA), coliforms, thermo-tolerant coliforms and presumptive E. coli, and Listeria monocytogenes) were performed. The results obtained were compared statistically. Both thawing strategies, thawing at 10 °C and −0.5 °C or at constant 10 °C, preserved good quality fish. The hygienic conditions during the thawing processes were satisfactory and there were no indications of impaired food safety during any of the thawing strategies. No pathogens were detected in any of the cod samples, nor in the thawing media. The results showed that water thawing at −0.5 to 10 °C is suitable for frozen cod, without compromising quality and safety, and that no significant difference were seen between the selected thawing temperature regimes.publishedVersio

Defining new reference intervals for serum free light chains in individuals with chronic kidney disease : Results of the iStopMM study

Publisher Copyright: © 2022. The Author(s). © 2022. The Author(s).Serum free light chain (FLC) concentration is greatly affected by kidney function. Using a large prospective population-based cohort, we aimed to establish a reference interval for FLCs in persons with chronic kidney disease (CKD). A total of 75422 participants of the iStopMM study were screened with serum FLC, serum protein electrophoresis and immunofixation. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine. Central 99% reference intervals were determined, and 95% confidence intervals calculated. Included were 6461 (12%) participants with measured FLCs, eGFR < 60 mL/min/1.73 m2, not receiving renal replacement therapy, and without evidence of monoclonality. Using current reference intervals, 60% and 21% had kappa and lambda FLC values outside the normal range. The FLC ratio was outside standard reference interval (0.26-1.65) in 9% of participants and outside current kidney reference interval (0.37-3.10) in 0.7%. New reference intervals for FLC and FLC ratio were established. New reference intervals for the FLC ratio were 0.46-2.62, 0.48-3.38, and 0.54-3.30 for eGFR 45-59, 30-44, and < 30 mL/min/1.73 m2 groups, respectively. The crude prevalence of LC-MGUS in CKD patients was 0.5%. We conclude that current reference intervals for FLC and FLC ratio are inaccurate in CKD patients and propose new eGFR based reference intervals to be implemented.Peer reviewe

Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey.

UNLABELLED: EUSOBI and 30 national breast radiology bodies support mammography for population-based screening, demonstrated to reduce breast cancer (BC) mortality and treatment impact. According to the International Agency for Research on Cancer, the reduction in mortality is 40 % for women aged 50-69 years taking up the invitation while the probability of false-positive needle biopsy is <1 % per round and overdiagnosis is only 1-10 % for a 20-year screening. Mortality reduction was also observed for the age groups 40-49 years and 70-74 years, although with "limited evidence". Thus, we firstly recommend biennial screening mammography for average-risk women aged 50-69 years; extension up to 73 or 75 years, biennially, is a second priority, from 40-45 to 49 years, annually, a third priority. Screening with thermography or other optical tools as alternatives to mammography is discouraged. Preference should be given to population screening programmes on a territorial basis, with double reading. Adoption of digital mammography (not film-screen or phosphor-plate computer radiography) is a priority, which also improves sensitivity in dense breasts. Radiologists qualified as screening readers should be involved in programmes. Digital breast tomosynthesis is also set to become "routine mammography" in the screening setting in the next future. Dedicated pathways for high-risk women offering breast MRI according to national or international guidelines and recommendations are encouraged. KEY POINTS: • EUSOBI and 30 national breast radiology bodies support screening mammography. • A first priority is double-reading biennial mammography for women aged 50-69 years. • Extension to 73-75 and from 40-45 to 49 years is also encouraged. • Digital mammography (not film-screen or computer radiography) should be used. • DBT is set to become "routine mammography" in the screening setting in the next future

Iceland screens, treats, or prevents multiple myeloma (iStopMM): a population-based screening study for monoclonal gammopathy of undetermined significance and randomized controlled trial of follow-up strategies.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadMonoclonal gammopathy of undetermined significance (MGUS) precedes multiple myeloma (MM). Population-based screening for MGUS could identify candidates for early treatment in MM. Here we describe the Iceland Screens, Treats, or Prevents Multiple Myeloma study (iStopMM), the first population-based screening study for MGUS including a randomized trial of follow-up strategies. Icelandic residents born before 1976 were offered participation. Blood samples are collected alongside blood sampling in the Icelandic healthcare system. Participants with MGUS are randomized to three study arms. Arm 1 is not contacted, arm 2 follows current guidelines, and arm 3 follows a more intensive strategy. Participants who progress are offered early treatment. Samples are collected longitudinally from arms 2 and 3 for the study biobank. All participants repeatedly answer questionnaires on various exposures and outcomes including quality of life and psychiatric health. National registries on health are cross-linked to all participants. Of the 148,704 individuals in the target population, 80 759 (54.3%) provided informed consent for participation. With a very high participation rate, the data from the iStopMM study will answer important questions on MGUS, including potentials harms and benefits of screening. The study can lead to a paradigm shift in MM therapy towards screening and early therapy.Black Swan Research Initiative by the International Myeloma Foundation Icelandic Centre for Research European Research Council (ERC) University of Iceland Landspitali University Hospita

Improved quality of herring for humans

Herring is one of the most important fish species in the North Atlantic and Baltic Sea, with an annual catch exceeding 2 million tonnes. Although a large part of these fish is used for human consumption, as much as 85% of the herring is used for industrial production of fish meal and fish oil. There is a general wish to increase the utilisation of herring for human consumption. Thus, it was important to study the various parameters which influence the quality of herring, and in particular how these paramenters are controlled by biological factors. A major reason behind quality problems arising during post harvest handling of herring is its high content of compounds that efficiently catalyzes the development of rancidity, pigmentation, texture changes and loss of nutritional value

The effects of pre-salting methods on salt and water distribution of heavily salted cod, as analyzed by ¹H and ²³Na MRI, ²³Na NMR, low-field NMR and physicochemical analysis

International audienceThe effect of different pre-salting methods (brine injection with salt with/without polyphosphates, brining and pickling) on the water and salt distribution in dry salted Atlantic cod (Gadus morhua) fillets was studied with proton and sodium NMR and MRI methods, supported by physicochemical analysis of salt and water content as well as water holding capacity. The study indicated that double head brine injection with salt and phosphates lead to the least heterogeneous water distribution, while pickle salting had the least heterogeneous salt distribution. Fillets from all treatments contained spots with unsaturated brine, increasing the risk of microbial denaturation of the fillets during storage: Since a homogeneous water and salt distribution was not achieved with the studied pre-salting methods, further optimizations of the salting process, including the pre-salting and dry salting steps, must be made in the future

Endoscopic retrograde cholangio- pancreatography. An overview of procedures at the Natinal University Hospital in Reykjavik 1983-1992

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenIntroduction: In this retrospective study we analysed all ERCP procedures performed at the National University Hospital in Reykjavik, Iceland, for the period 1983-1992. Material: A total of 644 procedures were performed on 477 patients. Results: The main indication for a diagnostic ERCP was suspected choledocholithiasis in 58.8% of cases. Cannulation of the papilla of Vater was successfully achived in 94% of patients and in 82% the desired duct was visualised. Juxtapapillary diverticula were found in 14.5% of patients. The success at cannulation was significally less in that group. Choledocholithiasis was found in 19.4% more often in the patients with diverticula, 29.5 vs. 18.8%. The number of therapeutic interventions was 158 performed on 84 patients (24.5% of all ERCP). The most common procedure was sphincterotomy, performed in 84% of cases. Stone extraction was successfully achived in 58% of all attempts. The overall complications rate was 7%, most frequently acute pancreatitis (4.7%) followed by cholangitis (1.9%) and bleeding (0.3%). The complications were mild in the majority of cases but serious ones did occur and were fatal in three (0.5%) patients related to severe pancreatitis. Conclusion: The results of this retrospective study in Iceland are comparable to what others have reported previously.Inngangur: Í þessari rannsókn voru kannaðar niðurstöður allra holsjárröntgenmynda af gallvegum og brisgangi (endoscopic retrograde cholangio- pancreatography, ERCP) sem framkvæmdar voru á Landspítalanum á árunum 1983-1992. Efniviður: Framkvæmdar voru 644 rannsóknir á 477 sjúklingum. Niðurstöður: Algengasta tilefnið var greining og meðferð steina í gallpípu (ductus choledochus) eða í 55,9% tilfella. Þræðing á hringvöðva í skeifugarnartotu (papilla Vateri) tókst í 93,5% tilrauna. Í 82% tilfella tókst rannsóknin fullkomlega, það er fylla tókst það gangakerfi sem sóst var eftir. Poki við skeifugarnartotuna (juxtapapillary diverticulum) fannst hjá 14,5% sjúklinga og tókst þræðing síður hjá þeim. Steinar í gallgangi sáust í 19,4% rannsókna gerðra í greiningarskyni og oftar hjá þeim er höfðu skeifugarnarpoka. í 24,5% rannsókna voru framkvæmdar aðgerðir, eða 158 aðgerðir á 84 sjúklingum. Oftast var framkvæmdur hringvöðvaskurður (papillotomia) eða í 84,2% aðgerða. Steinúrdráttur úr gallgangi tókst með vissu í 66,2% aðgerða. Aukaverkanir komu fyrir í 7% allra rannsókna og var brisbólga algengust (4,7%). Langflestar aukaverkanir voru vægar, en sex sjúklingar (1%) veiktust alvarlega, í öllum tilfellum var um svæsna brisbólgu að ræða og má rekja dauða þriggja þeirra beint eða óbeint til rannsóknarinnar. Ályktanir: Árangur holsjárröntgenmynda af gallvegum og brisgangi á Landspítalanum 1983-1992 er sambærilegur við niðurstöður rannsókna annarra, bæði hvað varðar tæknilega framkvæmd rannsóknarinnar og fylgikvilla

Endoscopic retrograde cholangio- pancreatography. An overview of procedures at the Natinal University Hospital in Reykjavik 1983-1992

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenIntroduction: In this retrospective study we analysed all ERCP procedures performed at the National University Hospital in Reykjavik, Iceland, for the period 1983-1992. Material: A total of 644 procedures were performed on 477 patients. Results: The main indication for a diagnostic ERCP was suspected choledocholithiasis in 58.8% of cases. Cannulation of the papilla of Vater was successfully achived in 94% of patients and in 82% the desired duct was visualised. Juxtapapillary diverticula were found in 14.5% of patients. The success at cannulation was significally less in that group. Choledocholithiasis was found in 19.4% more often in the patients with diverticula, 29.5 vs. 18.8%. The number of therapeutic interventions was 158 performed on 84 patients (24.5% of all ERCP). The most common procedure was sphincterotomy, performed in 84% of cases. Stone extraction was successfully achived in 58% of all attempts. The overall complications rate was 7%, most frequently acute pancreatitis (4.7%) followed by cholangitis (1.9%) and bleeding (0.3%). The complications were mild in the majority of cases but serious ones did occur and were fatal in three (0.5%) patients related to severe pancreatitis. Conclusion: The results of this retrospective study in Iceland are comparable to what others have reported previously.Inngangur: Í þessari rannsókn voru kannaðar niðurstöður allra holsjárröntgenmynda af gallvegum og brisgangi (endoscopic retrograde cholangio- pancreatography, ERCP) sem framkvæmdar voru á Landspítalanum á árunum 1983-1992. Efniviður: Framkvæmdar voru 644 rannsóknir á 477 sjúklingum. Niðurstöður: Algengasta tilefnið var greining og meðferð steina í gallpípu (ductus choledochus) eða í 55,9% tilfella. Þræðing á hringvöðva í skeifugarnartotu (papilla Vateri) tókst í 93,5% tilrauna. Í 82% tilfella tókst rannsóknin fullkomlega, það er fylla tókst það gangakerfi sem sóst var eftir. Poki við skeifugarnartotuna (juxtapapillary diverticulum) fannst hjá 14,5% sjúklinga og tókst þræðing síður hjá þeim. Steinar í gallgangi sáust í 19,4% rannsókna gerðra í greiningarskyni og oftar hjá þeim er höfðu skeifugarnarpoka. í 24,5% rannsókna voru framkvæmdar aðgerðir, eða 158 aðgerðir á 84 sjúklingum. Oftast var framkvæmdur hringvöðvaskurður (papillotomia) eða í 84,2% aðgerða. Steinúrdráttur úr gallgangi tókst með vissu í 66,2% aðgerða. Aukaverkanir komu fyrir í 7% allra rannsókna og var brisbólga algengust (4,7%). Langflestar aukaverkanir voru vægar, en sex sjúklingar (1%) veiktust alvarlega, í öllum tilfellum var um svæsna brisbólgu að ræða og má rekja dauða þriggja þeirra beint eða óbeint til rannsóknarinnar. Ályktanir: Árangur holsjárröntgenmynda af gallvegum og brisgangi á Landspítalanum 1983-1992 er sambærilegur við niðurstöður rannsókna annarra, bæði hvað varðar tæknilega framkvæmd rannsóknarinnar og fylgikvilla