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Biomedical subjects

C Lundstedt

Publications and source records attributed to C Lundstedt.

At least 19 recordsLinked to original sources
PubMed1998

[Influenza vaccination of the elderly in the municipality of Copenhagen].

In October/November 1996 all people living in the city of Copenhagen aged 70 and above were invited to receive an influenza vaccination. Of a total of 62,600 people, 35,423 were vaccinated which is a participation rate of 56%. The participation rate increased with increasing age and in the older age groups the participation rate was 80%. The vaccinations were performed by nurses and most of the participants were vaccinated in special clinics (74.9%). Immobile participants were vaccinated either in their own homes (14.3%), in nursing homes (9.2%), or in hospitals (1.6%). One single case of hospitalisation of a chronically ill patient was registered, because of a weak influenza. No other side effects were registered. The total cost of all vaccinations was 4 million dkr. which is 115 dkr. (approximately 10 Pounds sterling) for each vaccination.

Aged↗
PubMed1998

Intraluminal duodenal diverticulum causing pancreatitis in a patient with a polysplenia syndrome.

A 19-year-old female had recurrent bouts of pancreatitis. At endoscopy a mucosa-covered mass lesion was seen in the duodenum. A double-contrast examination of the stomach and duodenum showed an intraluminal duodenal diverticulum (IDD). Also an inversed abdominal situs and a midgut malrotation were noted. Computed tomography revealed evidence of a polysplenia syndrome. Although this syndrome is associated with various gastrointestinal abnormalities, its combination with an IDD does not seem to have been reported previously. After surgical removal of the IDD the patient has not had any further attacks of pancreatitis.

Acute Disease↗
PubMed1998

Computed tomography and laparoscopy in the assessment of the patient with pancreatic cancer.

BACKGROUND: In most patients with pancreatic cancer, the tumor is unresectable. Nonoperative methods for palliation of jaundice, duodenal obstruction, and pain currently are being developed. Preoperative assessment of resectability of the tumor is becoming more and more important to avoid unnecessary operations. The aim of this study was to compare computed tomography (CT) and laparoscopy with special reference to the additive role of the latter technique in predicting unresectability of pancreatic cancers. STUDY DESIGN: Sixty patients with exocrine pancreatic cancer were assessed prospectively with both CT and laparoscopy. On the basis of metastatic spread or signs of vascular involvement, the radiologist and the laparoscopist independently reported the tumors as probably unresectable or resectable. RESULTS: The predictive value for unresectability was 100% for both CT and laparoscopy. Sensitivity in predicting unresectability was 69% for both techniques, and the corresponding figure for specificity was 100%. When CT and laparoscopy were evaluated together, an improvement in sensitivity to 87% was observed (p < 0.05). Separately, CT and laparoscopy correctly predicted resectability in only 30% and 38% of the patients, respectively. The presence of liver metastases was overlooked by CT in 13 of 32 patients (40%). Every fourth patient who was found to have unresectable tumor at CT was falsely classified as resectable by the laparoscopist, leading to unnecessary laparotomies. On the other hand, 9 of 24 patients (38%) with resectable disease at CT were deemed unresectable at the subsequent laparoscopy. CONCLUSIONS: Laparoscopy and CT independently and reliably predicted unresectability of pancreatic cancer, but the methods were inaccurate in forecasting resectability. The results suggest that CT examination should be done in patients who are candidates for attempted curative surgical procedures, whereas laparoscopy should be restricted to Those Judged resectable at CT.

Humans↗
PubMed1997

Intravascular ultrasound for evaluation of portal venous involvement in pancreatic cancer.

The aim of this study was to evaluate the accuracy of intravascular ultrasound (IVUS) in diagnosing tumour involvement of the portal vein in patients with exocrine cancer of the head of the pancreas. Seven consecutive patients with a preoperative diagnosis of carcinoma, preoperatively deemed to be resectable, were examined with IVUS of the portal vein during surgery. The IVUS catheters were 6.2 F (2.0 mm) in diameter with a 20-MHz transducer and were introduced into the portal vasculature through the mesenteric superior vein. All patients had tumour extending to the portal vein as demonstrated at histopathological examinations in six cases and at surgical dissection in one case. The IVUS technique correctly identified all these patients, whereas five patients were incorrectly deemed at surgery not to have tumour involvement of the portal vein. These results indicate that IVUS is a very sensitive method for the evaluation of tumour involvement of the portal vein.

Aged↗
PubMed1996

[An outbreak of Streptococcus pyogenes infections in institutions for the mentally retarded in Greater Copenhagen 1995].

The largest reported outbreak of infections due to Streptococcus pyogenes, M-type 18, in recent years is described. Ninety persons at institutions for mentally retarded (73% residents) had infections due to the epidemic strain. Pharyngitis and scarlatina were the most common infections. Six patients died, five having a streptococcal toxic shock syndrome. During the outbreak an intensive surveillance was carried out together with improved infection control measures and prompt culturing of residents and employees before antimicrobial treatment. The primary outbreak was confined but a secondary outbreak could not be prevented. This was probably due to difficulties in implementing proper isolation precautions in this setting.

Adult↗
PubMed1996

Imaging of tuberculosis--experience from 503 patients. I. Tuberculosis of the chest.

PURPOSE: To give an overview of 503 patients with tuberculosis (TB) and to describe the radiologic findings of chest TB. MATERIAL AND METHODS: A total of 503 patients with proven TB were reviewed; 266 had chest involvement. RESULTS: Lung lesions were demonstrated in 214 patients. Infiltrates in the basal parts of the lungs or pleural effusion were often primarily mistaken for viral or bacterial infections. Consolidations within the lungs and pleural thickening were sometimes indistinguishable from malignancy. Positive culture of the sputum without lung lesions was encountered in 12 cases. Enlarged mediastinal lymph nodes were demonstrated in 67 cases, 35 without lesions in the lungs. The lymphadenopathy could be extensive, and both clinically and radiologically indistinguishable from lymphoma. CONCLUSION: Due to the present increase in incidence of TB and the fact that TB can mimic many other conditions, it is important that both clinicians and radiologists have TB high on the list for differential diagnoses.

Adolescent↗
PubMed1996

Imaging of tuberculosis. II. Abdominal manifestations in 112 patients.

PURPOSE: To describe the radiological findings of tuberculosis (TB) of the abdomen as reflected at our hospital. MATERIAL AND METHODS: The radiological files of 503 patients (referred to our institution mainly because of a clinical suspicion of malignancy, and found to have culture- or biopsy-proven TB) were reviewed in order to analyze the spectrum of the TB manifestations in this group of patients. RESULTS: Abdominal manifestations were found in 112 patients, in 1/3 abdominal disease was the only evidence of TB. More than half of the patients also had chest TB. The most common abdominal TB manifestations were peritonitis and lymph node enlargement, each occurring in about 1/3 of the patients. Also 1/3 had genitourinary TB manifestations. About 1/5 had TB of the liver, spleen or pancreas or in the gastrointestinal tract, respectively. Multiple organ involvement was common. CONCLUSION: The need to consider TB in the differential diagnosis in patients with obscure abdominal symptoms, especially with multiple organ involvement, is stressed.

Adolescent↗
PubMed1996

Imaging of tuberculosis. III. Tuberculosis as a mimicker of brain tumour.

PURPOSE: To show that intracranial tuberculosis (TB) often masquerades as brain tumour. MATERIAL AND METHODS: Forty-six patients with intracranial TB, who after CT at the local hospital were referred for surgery or radiotherapy of brain tumour, are presented. Sometimes the correct diagnosis was first established during surgery for brain tumour. RESULTS: The differentiation between TB and gliomas, meningiomas, metastases, or lymphomas may be impossible from the clinical history and CT findings. Angiography, done in 25 of our cases, often helped by not showing the expected tumour vasculature. MR, performed in 9 patients, helped by demonstrating a layered capsule on T2-weighted images in 4 of the lesions (hypointense rim outside hyperintense rim); the centres of the lesions were of decreased, usually very mixed T2 signal intensity. CONCLUSION: Even in patients with findings typical of brain tumour, TB remains an important differential diagnosis.

Adolescent↗
PubMed1996

Imaging of tuberculosis. IV. Spinal manifestations in 63 patients.

PURPOSE: To describe the radiologic findings in patients with spinal tuberculosis (TB). MATERIAL AND METHODS: Out of a total of 503 patients with TB, 63 (13%) had involvement of the spine. RESULTS: In 40 patients, the spine was the only location; 20 patients had concomitant chest TB. Conventional radiographs gave a good overview, CT visualized the disko-vertebral lesions and the paravertebral abscesses, while MR imaging was useful to determine the spread of disease to the soft tissues and the spinal canal. The typical findings were destroyed vertebrae with associated paraspinal soft-tissue mass, with or without abscess formation, sometimes also involving the epidural space together with adjoining disk lesion and focal gibbus formation. Involvement of a single vertebra was a relatively common finding. Large psoas abscesses could occur without any signs of bone involvement. The TB process could sometimes be indistinguishable from malignant processes, and in 3 patients, with multiple lesions in the spine, it mimicked metastatic disease. CONCLUSION: It is stressed that TB should always be considered in the differential diagnosis when radiologic findings suggest spinal infections or primary or secondary spinal tumors.

Adult↗
PubMed1996

Imaging of tuberculosis. V. Peripheral osteoarticular and soft-tissue tuberculosis.

PURPOSE: To assess frequency, location, and appearance of peripheral osteoarticular and soft-tissue tuberculosis (TB). MATERIAL AND METHODS: Twenty-five of 503 patients with TB had peripheral osteoarticular TB and 5 had soft-tissue TB. Chest radiography, CT, and MR imaging were applied. RESULTS: The location of the osteoarticular lesion was articular/epiphyseal in 14 patients, articular/metaphyseal in 3, and metaphyseal without joint involvement in 3. Involvement of flat bone was found in 4 patients (5 lesions). The morphologic appearance was similar to that of a lytic tumour in 9 patients (10 lesions) and that of a destructive joint lesion in 16 patients. The soft-tissue TB in all 5 patients presented as an abscess. Twelve patients had a total of 20 additional sites of involvement: chest in 9, abdomen in 4, spine in 4, the neck in 3, and the central nervous system in one patient. CONCLUSION: On the basis of radiologic appearance, it can be difficult to differentiate peripheral osteoarticular and soft-tissue TB from other degenerative, inflammatory, or neoplastic disorders, and the importance of a high awareness is stressed in order to reach an early diagnosis.

Adolescent↗
PubMed1996

Implantation metastases from gastrointestinal cancer after percutaneous puncture or biliary drainage.

OBJECTIVE: Evaluation of incidence and outcome of implantation metastases after percutaneous fine-needle biopsy or biliary drainage. DESIGN: Retrospective study. SETTING: University hospital, Sweden. SUBJECTS: Eight patients with implantation metastases from gastrointestinal cancers after percutaneous fine-needle biopsy (n = 7) or biliary drainage (n = 1). MAIN OUTCOME MEASURES: Incidence of implantation metastases, treatment and influence on outcome and survival. RESULTS: In two out of three patients who had had otherwise radical operations, the implantation metastases meant that the operations were palliative rather than curative. Patients who had had palliative resections of the implantation metastases developed major local complications. One patient is alive with no signs of disease after 106 months, while one is alive with disease 30 months after the diagnosis of the implantation metastases. The remaining patients have died after 6 to 23 months. CONCLUSION: The incidence of implantation metastases after fine-needle procedures is probably underestimated. There is a slight but definite risk that the procedure may render an otherwise curative resection palliative. Implantation metastases cause local complaints of varying severity and seems to have a tendency to recur locally. We recommend that fine-needle biopsy should be restricted to patients who will truly benefit from a more accurate preoperative diagnosis.

Adult↗