A Norwegian nationwide quality assurance project in nuclear medicine: total performance in bone scintigraphy measured with a new transmission phantom

A prototype version of a recently developed transmission phantom for simulation of radionuclide bone studies was used in a Norwegian nationwide quality assurance project. The design of the phantom made it possible to perform a receiver operation characteristic (ROC) examination with respect to the detection of radionuclide accumulation in the ribs. The participants were also asked to report accumulation in the spinal column. Images obtained by means of a uniform source and a four-quadrant bar pattern were used to judge resolution and homogeneity with the collimator used in the bone studies. The overall performance of the laboratories was satisfactory, but considerable variations were found. There was a marked correlation between the physician's performance and the resolution and homogeneity of the camera. Reports from stationary imaging were generally better than those that were based on whole-body scans.     

Soft-tissue sarcoma of the thigh: Surgical margin influences local recurrence but not survival in 152 patients

Between 1979 and 1998, 152 patients with a soft-tissue sarcoma arising in the thigh were surgically treated in the Sarcoma Center in Aarhus, Denmark. We studied clinicopathologic factors prognostic for local recurrence and survival. 27 patients (18%) had a low-grade tumor, 26 (17%) an intermediate-grade and 99 (65%) a high-grade tumor.

27 patients (18%) were amputated and 125 (82%) had a local resection. 21 (14%) underwent a marginal resection, 82 (54%) a wide resection and 49 (32%) a compartmental resection. 32 patients were also given radiotherapy, 11 of these had a marginal resection.

The 5-year local recurrence-free rate was 91%. Multivariate analysis selected marginal resection and histological high grade as unfavorable prognostic factors for local recurrence. The 5-year survival rate was 68%. High age and histological high grade were unfavorable prognostic factors for survival in a multivariate analysis. Surgical margin influenced local recurrence, but not the overall survival.     

Eating self-efficacy as predictor of long-term weight loss and obesity-specific quality of life after sleeve gastrectomy: A prospective cohort study

Background

A person's confidence to control eating, eating self-efficacy (ESE), has been identified as a target for long-term weight management in nonsurgical weight loss interventions, but has to a limited extent been studied after bariatric surgery.

Serum Galectin-3 and Subsequent Risk of Coronary Heart Disease in Subjects With Childhood-Onset Type 1 Diabetes: A Cohort Study

OBJECTIVETo study whether serum galectin-3 and other biomarkers of inflammation predict coronary heart disease (CHD) in subjects with long-standing childhood-onset type 1 diabetes.RESEARCH DESIGN AND METHODSA population-based nationwide cohort of 299 subjects with type 1 diabetes diagnosed in Norway at <15 years of age during 1973–1982 was examined in 2002–2003 at a mean age of 33 years (range 21–44), with mean diabetes duration of 24 years (range 19–30). Subjects were followed through 31 December 2017 for their first CHD event registered by a hospitalization or cause of death using nationwide registries. Stored serum samples were available for 296 subjects and analyzed for interleukin-6 (IL-6), IL-6 receptor, IL-18, hs-CRP, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), galectin-3, and high-sensitivity troponin T. Adjusted hazard ratios (aHRs) for CHD per SD increase in biomarker were estimated using Cox regression.RESULTSOf 295 subjects, 40 (13.6%) had a documented CHD event during a mean follow-up of 14.4 years (range 0.5–16). IL-6 (aHR 1.32 [95% CI 1.07–1.63]), galectin-3 (aHR 1.44 [95% CI 1.09–1.80]), and TIMP-1 (aHR 1.37 [95% CI 1.04–1.81]) were significant predictors of CHD after adjustment for conventional risk factors.CONCLUSIONSGalectin-3 was significantly associated with future CHD in subjects with type 1 diabetes, and if the results are replicated in larger studies, it may aid in prediction together with conventional risk factors for CHD.     

Educational Inequalities in Post‐Hip Fracture Mortality: A NOREPOS Studys

Hip fractures are associated with high excess mortality. Education is an important determinant of health, but little is known about educational inequalities in post‐hip fracture mortality. Our objective was to investigate educational inequalities in post‐hip fracture mortality and to examine whether comorbidity or family composition could explain any association. We conducted a register‐based population study of Norwegians aged 50 years and older from 2002 to 2010. We measured total mortality according to educational attainment in 56,269 hip fracture patients (NORHip) and in the general Norwegian population. Both absolute and relative educational inequalities in mortality in people with and without hip fracture were compared. There was an educational gradient in post‐hip fracture mortality in both sexes. Compared with those with primary education only, the age‐adjusted relative risk (RR) of mortality in hip fracture patients with tertiary education was 0.82 (95% confidence interval [CI] 0.77–0.87) in men and 0.79 (95% CI 0.75–0.84) in women. Additional adjustments for Charlson comorbidity index, marital status, and number of children did not materially change the estimates. Regardless of educational attainment, the 1‐year age‐adjusted mortality was three‐ to fivefold higher in hip fracture patients compared with peers in the general population without fracture. The absolute differences in 1‐year mortality according to educational attainment were considerably larger in hip fracture patients than in the population without hip fracture. Absolute educational inequalities in mortality were higher after hip fracture compared with the general population without hip fracture and were not mediated by comorbidity or family composition. Investigation of other possible mediating factors might help to identify new targets for interventions, based on lower educational attainment, to reduce post‐hip fracture mortality. © 2015 American Society for Bone and Mineral Research.