Polyarteritis nodosa in children: radiological aspects and diagnostic correlation

The radiological findings in 14 children with polyarteritis nodosa (PN) were evaluated in relation to clinical, laboratory, and histological findings. In this series, there were two major groups of radiological findings, one associated with renal insufficiency and the other with intestinal vascular insufficiency. No radiographic finding was pathognomonic. Two patients were suspected of having small bowel intussusception (SBI), and SBI was documented at laparotomy in a third patient. The diagnosis and management of PN in children is dependent upon the correlation of clinical and laboratory findings. Associated pertinent radiological features which may be useful in the management of children with PN are reviewed.     

Expressions of hope in cystic fibrosis patients: a comparison with the general population

PURPOSE: Hope was evaluated in Norwegian patients with cystic fibrosis (CF). PARTICIPANTS: The subjects were 87 Norwegian adults with CF and a control group of 1020 from the general population (GP). METHODS: Subjects completed a questionnaires that included the Herth Hope Index and demographic variables. Data on health-related variables were collected for the CF group. RESULTS: The mean age of the CF patients was 29 years (range 18-54). Almost 50% had a forced expiratory volume for one second percent predicted (FEV1%) below 50%, and 21% reported perceiving being in a bad phase of the disease. The CF patients reported lower (poorer) levels of hope than the GP sample, especially for the item scared about the future. However, they scored higher on inner strength and were younger, more often living alone, unmarried, not in paid work, but with similar educational levels. Levels of hope increased with increasing age in the CF patients but decreased for the GP subjects. The health variable that most affected hope in the CF sample was pulmonary function, not the presence of asthma or chronic lung infections. CONCLUSIONS: Persons growing up with CF experience many challenges. CF patients expressed slightly lower levels of hope and were more scared of the future. They scored higher on inner strength than the general population.     

Patients with cancer and their close relatives: experiences with treatment,care, and support

This article presents findings from a study of 536 patients with cancer and 473 of their close relatives from 15 different hospitals in Norway. The study assessed the satisfaction of both groups with the help and support they received from different sources such as family and friends, health personnel, and fellow patients. The results indicate that the patients received more support and information than their close relatives. The patients also were generally more satisfied with the support. Furthermore, the relatives seemed to underestimate the help and support provided to the patients. For both the patients and their close relatives, family and friends proved to be important sources of support. Regarding the public health services, almost 90% of the patients were very satisfied with the medical treatment. On the other hand, only an approximate 13% were very satisfied with information about alternative treatment and financial issues related to the disease. For the patients, the contact with fellow patients was highly valued. For most of the patients, this contact provided hope for the future, but it also had the potential for painful and sad feelings. The study was conducted in collaboration with the Norwegian Cancer Society to provide information that can be used for the guidance of health personnel and care of patients and their relatives.     

Sense of coherence predicts change in life satisfaction among home-living residents in the community with mental health problems: a 1-year follow-up study

Objectives There is a call for a further investigation of Sense of Coherence (SOC), the central concept in salutogenesis, and its relation to health and life satisfaction. No previous studies have investigated the utility of SOC versus mental symptoms for the prediction of life satisfaction among people with chronic mental health problems (MHP). Methods The present study has a prospective design including a baseline assessment and a 1-year follow up. We recruited 107 adults from the community health care system. SOC was measured by the Sense of Coherence questionnaire, mental symptoms by the Symptom Checklist-90 revised and life satisfaction by The Quality of Life Scale (all Norwegian versions). Results The results show that while SOC predicts change in life satisfaction (standardized beta coefficient for SOC was 0.39, P = 0.014), mental symptoms did not (standardized beta coefficient 0.00, P = 1.0). Conclusions These findings emphasize the importance of assessing factors that may explain differences in life satisfaction over and above mental symptoms among people with MHP. The results indicate that improving SOC among people with MHP might provide important opportunities for improving their life satisfaction.     

Less severe retinopathy of prematurity induced by surfactant replacement therapy

To assess the effect of surfactant replacement therapy (SRT) on the prevalence and severity of retinopathy of prematurity (ROP), we compared data from 160 SRT-treated preterm infants with data from 230 historic controls. The prevalence of ROP was 30.6% in the treatment group and 23.4% in the control group. Severe ROP (stages 3-4) was seen in 6.1% of the infants with ROP in the treatment group and 20.3% of the ROP patients in the control group. Surfactant therapy had no influence on the prevalence of ROP (odds ratio 1.4, 95% confidence interval 0.797-2.459, p = 0.242). However, SRT was associated with a decreased risk for severe ROP, compared to mild ROP (odds ratio 0.226, 95% confidence interval 0.056-0.905, p = 0.036). These data suggest that SRT is associated with a decreased risk for severe ROP.     

Cost differences between digital tomosynthesis and standard digital mammography in a breast cancer screening programme: results from the To-Be trial in Norway

Background

Several studies in Europe and the US have shown promising results favouring digital breast tomosynthesis compared to standard digital mammography (DM). However, the costs of implementing the technology in screening programmes are not yet known.

Methods

A randomised controlled trial comparing the results from digital breast tomosynthesis including synthetic mammograms (DBT) vs. DM was performed in Bergen during 2016 and 2017 as a part of BreastScreen Norway. The trial included 29,453 women and allowed for a detailed comparison of procedure use and screening, recall and treatment costs estimated at the individual level.

Results

The increased cost of equipment, examination and reading time with DBT vs. DM was €8.5 per screened woman (95% CI 8.4−8.6). Costs of DBT remained significantly higher after adding recall assessment costs, €6.2 (95% CI 4.6−7.9). Substantial reductions in either examination and reading times, price of DBT equipment or price of IT storage and connectivity did not change the conclusion. Adding treatment costs resulted in too wide confidence intervals to draw definitive conclusions (additional costs of tomosynthesis €9.8, 95% CI –56 to 74). Performing biopsy at recall, radiation therapy and chemotherapy was significantly more frequent among women screened with DBT.

Conclusion

The results showed lower incremental costs of DBT vs. DM, compared to what is found in previous cost analyses of DBT and DM. However, the incremental costs were still higher for DBT compared with DM after including recall costs. Further studies with long-term treatment data are needed to understand the complete costs of implementing DBT in screening.

     

Delayed hepatic CT scanning: increased confidence and improved detection of hepatic metastases

Fifty oncologic patients with suspected hepatic metastases were prospectively evaluated by dynamic sequential hepatic computed tomography (DSHCT) and by delayed iodine hepatic computed tomography (DICT) scanning. DICT scanning was performed 4-6 hours following administration of 60 g of intravenous iodine. Both techniques were evaluated for lesion definition relative to the adjacent hepatic parenchyma and for numbers of metastases detected. Metastases were detected by both techniques in 26 patients. Fifteen patients (58%) had lesions better defined by DICT. DICT scanning detected more metastases in seven of these 15 patients. In eight patients (31%), there was no difference between the two techniques in numbers of masses detected or lesion definition. In three cases (11%), metastases were more confidently identified on the initial or DSHCT scan. DICT scanning, as described, is useful in defining and detecting hepatic metastases, especially where there is questionable hepatic involvement or better quantification of size is necessary.