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Biomedical subjects

J Størmer

Publications and source records attributed to J Størmer.

At least 19 recordsLinked to original sources

The Tromsø study: registration of fractures, how good are self-reports, a computerized radiographic register and a discharge register?

In order to compare different methods of fracture registration, we sought all nonvertebral fractures suffered during 8 years (1988-95) among 21,441 persons invited to a survey in 1979/80. We registered a total of 54 hip fracture cases through three separate sources (self-report, computer linkage to the local radiographic archives, discharge register), whereas forearm fractures (a total of 291 cases) were registered through two separate sources (self-report, computer linkage to the radiographic archives). The registration of fractures at other sites (a total of 1321 cases) were from one source (computer linkage to the local radiographic archives), and we have compared three ways of obtaining data from this single source (no ascertainment, ascertainment of records coded as fracture, ascertainment of all records). Ninety-three percent of all hip fractures and 97% of all wrist fractures in the entire study population were found by computer linkage to the radiographic archives, whereas the discharge register detected 87% of all the hip fractures. Computer linkage with ascertainment gave no overreporting of fractures. Among the 11,626 persons who answered a follow-up questionnaire in 1994/95, 97% (CI 84-100%) of all hip fractures and 72% (CI 66-78%) of all wrist fractures were self-reported. We conclude that a computerized search of radiographic archives is a viable method of fracture registration.

Adult↗

The Tromsø Study: physical activity and the incidence of fractures in a middle-aged population.

We have studied the relation of occupational and recreational physical activity to fractures at different locations. All men born between 1925 and 1959 and all women born between 1930 and 1959 in the city of Tromsø were invited to participate in surveys in 1979-1980 and 1986-1987 (The Tromsø Study). Of 16,676 invited persons, 12,270 (73.6%) attended both surveys. All nonvertebral fractures (n = 1435) sustained from 1988 to 1995 were registered in the only hospital in the area. Average age in the middle of the follow-up period (December 31, 1991) was 47.3 years among men and 4501 years among women, ranging from 32 to 66 years. Fracture incidence increased with age at all locations among women, but it decreased with or was independent of age among men. Low-energetic fractures constituted 74.4% of all fractures among women and 55.2% among men. When stratifying by fracture location, the most physically active persons among those 45 years or older suffered fewer fractures in the weight-bearing skeleton (relative risk [RR] 0.6, confidence interval [CI] 0.4-0.9, age-adjusted), but not in the non-weight-bearing skeleton (RR 1.0, CI 0.7-1.2, age-adjusted) compared with sedentary persons. The relative-risk of a low-energetic fracture in the weight-bearing skeleton among the most physically active middle-aged was 0.3 (CI 0.1-0.7) among men and 0.9 (CI 0.4-1.8) among women compared with the sedentary when adjusted for age, body mass index, body height, tobacco smoking, and alcohol and milk consumption. It seems that the beneficial effect on the skeleton of weight-bearing activity is reflected also in the incidence of fractures at different sites.

Adult↗

[Introduction of teleradiology].

Against the background of Norwegian conditions, the authors outline the equipment needed to launch a teleradiology unit, and what the clinician using the unit might expect of such an imaging facility. They also discuss whether the unit should be organised with the needs of emergency care in mind or as an integrated part of everyday routine at the radiology department, how financing and judicial issues have been managed so far, and whether the introduction of teleradiology might effect relationships between health care personnel and patients.

Humans↗

Receiver operating characteristic study of image preprocessing for teleradiology and digital workstations.

The purpose of this study was to evaluate whether digitized analog images displayed on a digital workstation can be improved by using a preprocessing algorithm, and if so, whether the quality of the resulting images can reach that of the original films. The material contained 120 difficult cases (about 50% with selected pathology). Four radiologists each evaluated half of the randomly ordered cases with the digital workstation and half of the cases with the original radiographs. The data were compared with a previous similar study, where the workstation had no option for preprocessed images. Preprocessed digital images were clearly superior to digital images without preprocessing, although for those of the highest diagnostic difficulty they were inferior to the original films. The preprocessing algorithm has improved the diagnostic quality of the digital workstation. There is room yet for improvement compared to plain films, although the current setup may be sufficient in some settings.

Bone and Bones↗

ROC-study of a teleradiology workstation versus film readings.

PURPOSE: We have used receiver operating characteristic (ROC) analysis to compare screen assessment of digitized radiographic films transmitted by a teleradiology system, with evaluation of the original radiographs on film. MATERIAL AND METHODS: The material contained 120 cases (about 50% with selected pathology) that were difficult to diagnose. Four radiologists each evaluated half of the cases on film, and half on computer screen. The screen display was 1024 x 836 pixels with 8 bits/pixel. RESULTS: We found the accuracy and sensitivity of the teleradiology system to be clearly inferior to film evaluation. CONCLUSION: Improvement is needed both in the teleradiology system, and in the training of radiologists to work on the electronic workstation.

Baltimore↗

Four years with teleradiology: a technical description.

Since September 1992, Troms Military Hospital (Norway) has been connected to the larger University Hospital of Tromsø by a teleradiology link transmitting about 6000 examinations annually. In the spring of 1995, the system was upgraded with a digital X-ray unit, thereby almost eliminating the scanning of analog radiographs. This article describes the technical development of the link. The discussion suggests ways of improving the teleradiology link, particularly in terms of integrating the radiology information system (RIS) and picture archiving and communication system (PACS).

Computer Communication Networks↗

Short-term treatment of Graves' disease with methimazole in high versus low doses.

OBJECTIVES: To compare the relapse rates in Graves' disease the first 2 years after methimazole 60 mg day-1 combined with thyroxine versus a titration regimen with methimazole alone, and to look for possible prognostic factors. DESIGN: A randomized, open, prospective study. Methimazole was given for 6 months in both groups, and thyroid status evaluated every 3rd month during the first year, and every 6th month during the second year. SETTING: The study was performed at our outpatient clinic with patients referred from primary care. SUBJECTS: Fifty-six patients were included. One became pregnant and one dropped out during the treatment period. Furthermore, nine patients in the high-dose and four in the low-dose group stopped the treatment because of side-effects. Thus, 19 patients in the high- and 22 in the low-dose group completed 6 months with methimazole. RESULTS: In those tolerating the treatment, the relapse rates in the high- and low-dose groups were 26.3 vs. 59.1% (P < 0.05), 42.1 vs. 77.3% (P < 0.02); and 57.9 vs. 77.3% (NS) after 3, 12 and 24 months, respectively. The corresponding relapse rates calculated on an 'intention to treat' basis were: 51.7 vs. 66.7%; 62.1 vs. 81.5%: 72.4 vs. 81.5% (NS). The thyroid volume was significantly (P < 0.05) larger in those that relapsed (17.8 +/- 2.9 vs. 11.6 +/- 1.2 mL; mean +/- SEM). CONCLUSIONS: In those tolerating the treatment, methimazole significantly reduced the relapse rate the 1st year when given in a high dose. However, the relapse rates in both groups, and the number of side-effects in the high-dose group, were unacceptably high.

Adult↗

[The personal computer for administrative routines at a radiology department].

The article describes a radiological information system (RIS) developed by members of the medical staff at a university hospital. Software has been developed on the basis of the two common databases; dBASE III plus and Clipper. The system is modular constructed. Each module can be operated individually, but best function is obtained by networking in a Ethernet (3Com). The article describes the different modules, user experience and future plans for development.

Diagnosis, Computer-Assisted↗

[Breast tumor--a diagnostic challenge].

The study includes all patients referred for surgical examination with suspected breast cancer (n = 439) during a single year. All women were examined clinically. Mammography was performed in 372 cases (88%), and 195 (46%) women underwent biopsy. 37 (8.7%) of the admitted women had breast cancer, which was verified by histological examination. This corresponds to an incidence rate of 0.8 per 1,000 women, and an incidence rate of 2.0 per 1,000 in women above 40 years. In four patients who were not suspected as having breast cancer after clinical examination, breast cancer was revealed by mammography. However, mammography alone is insufficient, since three mammograms were false negative, in cases where cancers were diagnosed clinically. Therefore, both mammography and clinical investigation are necessary in the examination of women with breast tumors. When breast cancer cannot be ruled out by physical and mammographic examination, a representative specimen of the tumor should be removed for histological or cytological examination.

Adult↗

[Mammography screening in Tromsö. Realization and results of the first mammography screening in Norway].

The screening was carried out as a part of a health survey. Women aged 40 or more, (N = 4,290), were eligible. The acceptance rate were 84.4%. Altogether 5.3% was selected fro detailed mammographic examination, 1.7% were referred to a surgeon and 1.1% underwent surgery. In ten (25%) of them breast cancer was proven histologically. The mammograms were read independently by two radiologists. The predictive value was highest if only women on which both radiologists agreed were referred to detailed mammography. Of the women attending the health survey, 98% in the urban and, 79% in the rural part of the municipality were screened for breast cancer. The latter group had to make an appointment and travel to the city center to have their mammograms taken. The interpretation of the breast cancer screening was centrally administered. The follow-up was organized locally.

Adult↗

The incidence of peptic ulcer disease related to occupation in the northern part of Norway. A prospective epidemiological and radiological study.

From a prospective epidemiological and radiological study of peptic ulcer disease in the northern part of Norway, relations between occupation and the occurrence of new peptic ulcers are presented. Over a 3-year period 1861 patients with dyspeptic complaints, 557 women and 1304 men belonging to 12 different occupational groups, were studied. Special attention was paid to the fishing population, constituting 2488 men and only 55 women. In the period studied 87 gastric ulcers and 118 duodenal ulcers were found. A statistically significantly higher incidence of both gastric and duodenal ulcers was found in fishermen than in the other groups. Furthermore, significantly higher incidences of duodenal ulcers were found in men occupied in 'land or water transport'. Compared with the total male population at risk in the area studied, significantly higher incidences were found for duodenal ulcer in fishermen. The present study confirms prior reports both from Scotland and from North Norway, showing an increased incidence of peptic ulcers in the fishing population.

Adolescent↗