A Nordic survey on artificial intelligence in the radiography profession - Is the profession ready for a culture change?

INTRODUCTION: The impact of artificial intelligence (AI) on the radiography profession remains uncertain. Although AI has been increasingly used in clinical radiography, the perspectives of the radiography professionals in Nordic countries have yet to be examined. The primary aim was to examine views of Nordic radiographers 'on AI, with focus on perspectives, engagement, and knowledge of AI. METHODS: Radiographers from Denmark, Norway, Sweden, Iceland, Greenland, and the Faroe Island were invited through social media platforms to participate in an online survey from March to June 2023. The survey encompassed 29-items and included 4 sections a) demographics, b) barriers and enablers on AI, c) perspectives and experiences of AI and d) knowledge of AI in radiography. Edgars Schein's model of organizational culture was employed to analyse Nordic radiographers' perspectives on AI. RESULTS: Overall, a total of 421 respondents participated in the survey. A majority were positive/somewhat positive towards AI in radiography e.g., 77.9 % (n = 342) thought that AI would have a positive effect on the profession, and 26% thought that AI would reduce the administrative workload. Most radiographers agreed or strongly agreed that clinicians may have access to AI generated reports (76.8 %, n = 297). Nevertheless, a total of 86 (20.1%) agree or somewhat agreed that AI a potential risk for radiography. CONCLUSION: Nordic radiographers are generally positive towards AI, yet uncertainties regarding its implementation persist. The findings underscore the importance of understanding these challenges for the responsible integration of AI systems. Carefully weighing the expected influence of AI against key incentives will support a seamless integration of AI for the benefit not just of the patients, but also of the radiography profession. IMPLICATIONS FOR PRACTICE: Understanding incentives factors and barriers can help address uncertainties during implementation of AI in clinical practice.

Ultrasound education across European Federation of Radiographers Societies (EFRS) countries: Similarities and differences.

INTRODUCTION: Ultrasound education varies greatly across European healthcare systems. This paper focuses on ultrasound academic education as a part of wider suite of surveys on radiographers working in ultrasound. The aim was to investigate sonography educational levels, methods of training, course duration and other factors in European Federation of Radiographers Societies (EFRS) member countries. METHOD: In 2019 an online survey was sent to the 38 EFRS member societies to distribute to higher education institutions within their own country. The survey was in English and contained different types of questions such as closed questions, free text options, and scale responses, to investigate sonography education including academic course types and duration, curriculum content, learning and teaching methods. RESULTS: A total of 45 responses were received, showing wide variation in the duration of training between the respective countries. Academic level 7 (part-time) ultrasound education was most frequently reported (n = 13), followed by direct entry ultrasound courses (n = 9) and bachelor's degree programmes at EQF level 6 (n = 7). The duration of part-time courses ranged from nine months up to four years. CONCLUSION: Sonography training and education varies among EFRS member countries ranging from short focused courses to postgraduate awards. Few countries offer sonography education leading to an award. The majority of clinical teaching and learning takes place in the learner's workplace. IMPLICATIONS FOR PRACTICE: High quality academic and clinical education for radiographers extending their role into ultrasound is important to ensure safe, effective sonography practice and good patient care.

Reporting radiographers within the European Federation of Radiographer Society (EFRS) member countries - motivation for becoming a reporting radiographer.

INTRODUCTION: Radiographer-led reporting originated in the United Kingdom as a strategy to reduce reporting backlog and time taken to report images. The effectiveness of reporting radiographers has been demonstrated, but their motivational factors have not been thoroughly explored. This survey aims to understand the incentives for radiographers to pursue postgraduate education in reporting radiography across Europe. METHODS: An online survey was conducted, collecting data across a range of topics such as demographic information, professional role, and job satisfaction. Questions assessing the influence of motivational factors on the decision to become a reporting radiographer are presented in this study. Descriptive statistics characterized the respondents' demographics. The motivational aspects were analysed quantitatively by regression analyses. Thematic analyses were performed for the free text responses on motivational aspects. RESULTS: 239 respondents from the UK, Denmark, Norway, Sweden, The Netherlands, Ireland, and Malta completed the survey's motivation section. Increased knowledge and new challenges were the most motivating factors for becoming a reporting radiographer, while less exposure to radiation and less patient contact were the least motivating factors. Job satisfaction was a significant motivator. Gender significantly correlated with the importance of social connections for female reporting radiographers. A cross-country comparison showed that title and position and job security were more important for reporting radiographers from the UK. CONCLUSION: Taking in consideration that a sample of 239 is not generalisable for the role, this survey does provides insights into the motivation behind being a reporting radiographer in Europe. Factors such as increased knowledge, new challenges, and job satisfaction play significant roles. Hindrances experienced by reporting radiographers included lack of time, support, and standards, while aspirations for further professional development were expressed. IMPLICATIONS FOR PRACTICE: A thorough understanding of the motivation behind pursuing postgraduate studies in reporting radiography is a valuable tool for managers, aiding in fostering a positive work environment and attracting/keeping qualified personnel. The findings of this study can be employed in the development of strategies to support and enhance the practice of reporting radiographers.

Nordic radiographers' and students' perspectives on artificial intelligence - A cross-sectional online survey.

INTRODUCTION: The integration of artificial intelligence (AI) into the domain of radiography holds substantial potential in various aspects including workflow efficiency, image processing, patient positioning, and quality assurance. The successful implementation of AI within a Radiology department necessitates the participation of key stakeholders, particularly radiographers. The study aimed to provide a comprehensive investigation about Nordic radiographers' perspectives and attitudes towards AI in radiography. METHODS: An online 29-item survey was distributed via social media platforms to Nordic students and radiographers working in Denmark, Norway, Sweden, Iceland, Greenland, and the Faroe Islands including items on demographics, specialization, educational background, place of work and perspectives and knowledge on AI. The items were a mix of closed-type and scaled questions, with the option for free-text responses when relevant. RESULTS: The survey received responses from all Nordic countries with 586 respondents, 26.8% males, 72.1% females, and 1.1% non-binary/self-defined or preferred not to say. The mean age was 37.2 with a standard deviation (SD) of ±12.1 years, and the mean number of years since qualification was 14.2 SD ± 10.3 years. A total of 43% (n = 254) of the respondents had not received any AI training in clinical practice. Whereas 13% (n = 76) had received AI during radiography undergrad training. A total of 77.9% (n = 412) expressed interest in pursuing AI education. The majority of respondents were aware of the potential use of AI (n = 485, 82.8%) and 39.1% (n = 204) had no reservations about AI. CONCLUSION: Overall, this study found that Nordic radiographers have a positive attitude toward AI. Very limited training or education has been provided to the radiographers. Especially since 82.8% reports on plans to implement AI in clinical practice. In general, awareness of AI applications is high, but the educational level is low for Nordic radiographers. IMPLICATION FOR PRACTICE: This study emphasises the favourable view of AI held by students and Nordic radiographers. However, there is a need for continuous professional development to facilitate the implementation and effective utilization of AI tools within the field of radiography.

Advances in the evaluation and treatment of autoimmune hepatitis.

PURPOSE OF REVIEW: The primary therapy of autoimmune hepatitis (AIH) has been established for over three decades. This review focuses on updates in the evaluation and management of patients with AIH. RECENT FINDINGS: The evaluation of patients has recently been updated to include more definitive screening for other autoimmune diseases, including thyroid disease and celiac disease. Antibody detection by ELISA, an easier and more commonly available method, has been incorporated into the latest iteration of the AIH scoring system. Corticosteroids and AZA remain the backbone of AIH treatment, but there is growing evidence for mycophenolate mofetil as both first-line and second-line therapy, and growing inquiry into calcineurin inhibitors. Noninvasive markers of liver disease have now been validated in AIH, with the strongest evidence for VCTE in patients with minimal hepatic inflammation. SUMMARY: Recent research of alternative immunosuppressant therapies, noninvasive markers of fibrosis, and updated society guidelines, have improved our ability to evaluate, treat, and follow patients with AIH.

Radiographers use of social media - SoMe in a Nordic perspective.

INTRODUCTION: Social media (SoMe) is widely used as a communication platform in everyday life. Also, healthcare professionals have embraced SoMe as a communication tool for both peers and patients. It is becoming an interactive tool for discussing professionals' issues and a place where learning and education occur. This study explores the specific patterns of SoMe use for radiographers' in the Nordic countries. The aim of this survey was to investigate radiographers use of social platforms in a professional setting. METHODS: A 29-item survey was prepared, and pilot-tested. The survey was produced in Danish a language that all Nordic countries master. In general, most Nordic languages are very similar. The survey was distributed by online platforms such as Facebook, LinkedIn, Twitter/X, and also distributed by newsletters by the Norwegian and Danish national radiographers societies. All data was collected anonymously. An Ethical Research approval was obtained from the University of Southern Denmark. RESULTS: A total of 242 respondents completed the survey (Denmark n = 183, Norway n = 48, Sweden n = 8, and n = 3 from other Scandinavian countries). The respondents included 186 females, 52 males and four were undisclosed. On average, the respondents spent approximately 2 h and 23 min daily on SoMe, with 27 min specifically dedicated to content relevant to radiographers. Facebook was the preferred platform with 93 % (n = 226). A total of 5.4 % (n = 13) respondents had experienced contact from patients and/or next of kin, while 92 % (n = 222) reported no such interactions and 2.9 % (n = 7) were undisclosed. A total of 52.8 % (n = 128) used SoMe in relation to courses, conferences, or online meetings. This shows that time spent on content relevant to radiographers imply that SoMe can be a relevant tool for reaching radiographers. CONCLUSION: The survey demonstrates radiographers' use of SoMe for personal and professional interest, with Facebook as the preferred social media platform. SoMe were mostly used during courses, conferences, or online meetings with half of the respondent reported using SoMe platforms during working hours. These results underscore the untapped potential of SoMe in professional healthcare settings. Additionally, the study offers insight into current practices, facilitating comparisons to identify trends in SoMe usage within the radiographer community. IMPLICATIONS FOR PRACTICE: The findings advocate for the strategic use of SoMe by radiographers', emphasizing professional networking and knowledge sharing. However, clear guidelines are necessary to ensure patient confidentiality and data security in these digital interactions.

Sonographers' perspectives on research - A worldwide online questionnaire study.

INTRODUCTION: Research has been performed by sonographers (also known as ultrasound reporting radiographers) for many years for improving diagnosis of disease, developing new imaging approaches, and enhancing patient outcomes. Despite this, sonographers' perspectives on research have not been well studied. To understand the views of sonographers is essential, as they have an important role in the successful implementation of research outcomes during their daily work. The study aimed to explore sonographers' perspectives on research. METHODS: This cross-sectional online questionnaire was developed, and pilot tested, before distribution on social media platforms by the research group to sonographers or reporting radiographers in ultrasound worldwide. The questionnaire included 21-items. The link was open for 8 weeks in the spring of 2023. A mix of closed, open and scale questions were used. Informed consent was mandatory, and information about the study and anonymity was presented. RESULTS: A total of 165 sonographers participated in the questionnaire of which 66.1 % were from Europe (n = 109), 6.1 % from North America (n = 10), 0.6 % from South America (n = 1), 2.4 % from Asia (n = 4), 13.3 % from Africa (n = 22) and 11.5 % from Oceania (n = 19). A total of 32 % of the participants had performed research. Also, 68.5 % would like to become more involved in research. CONCLUSION: Most sonographers work in large hospitals, and half of them have obtained academic level 7 education. A limited number of sonographers have published peer reviewed papers. Many sonographers expressed an interest in research. This suggests a potential for future development of the sonographers' role in research. IMPLICATIONS FOR PRACTICE: The findings for this study provide insight that could be used to improve research practice for sonographers.

Reporting radiographers in Europe survey: Support, role satisfaction, and advanced clinical practice within the European federation of radiographer society (EFRS) member countries.

INTRODUCTION: Increasing number of radiographers are undertaking image reporting throughout Europe. However, there are variations in practice and experience in European countries. The study aim was to investigate reporting radiographer's perceptions in relation to support for their role and workload satisfaction and elements of advanced practice that may also be undertaken. METHODS: Following institutional ethical approval an online 34 item questionnaire survey was circulated via social media; Twitter, Facebook, and LinkedIn in a 12-week period in 2022 across Europe. The survey data were managed by the online secure database REDCap (Research Electronic Data Capture). Data was collected across a range of questions, of which those relating to support for, and barriers to radiographer reporting, role and job satisfaction, and other role elements are reported here. RESULTS: A response level of 345 individual reporting radiographers replied to the survey from 15 European countries; some questions were optional and therefore had a lower response rate. There was consensus about the need for support from radiologists and management, protected time, and funding to support the reporting role. The majority of respondents received additional pay for taking on this role and expressed satisfaction with their role and workload. In relation to elements of advanced practice, the majority of respondents were involved in educational and managerial activities, and there was interest, but limited involvement, in research. CONCLUSION: There was a consensus about the support needed, and perceived barriers to, radiographer reporting, between reporting radiographers from different countries. Whilst there is some commonality in relation to activities such as supervision and education, there was clearer variety in relation to opportunities for research between the respondents, perhaps reflecting the differences between reporting as a standalone role development and reporting as part of an advanced clinical practice role. IMPLICATIONS FOR PRACTICE: As there is increasingly an emphasis on advanced clinical practice, reporting radiographers are likely to require support to develop their skills so that they can actively participate in the broader activities associated with this role, including education, leadership, and research.

Reporting radiographers in Europe survey: An overview of the role within the European Federation of Radiographer Society (EFRS) member countries.

INTRODUCTION: Reporting radiographers undertake an important role in healthcare and for the radiographer profession in general. First introduced in the United Kingdom, reporting radiographers are now practicing in several other European countries. Our objective was to investigate the workforce of reporting radiographers across the European Federation of Radiographer Societies (EFRS) community. METHOD AND MATERIAL: A voluntary anonymous 34 item electronic survey was distributed online using social media accounts such as Twitter, Facebook and LinkedIn covering a wide range of topics relating to professional role, advanced practice, education, and seniority. The questionnaire was distributed during a 12-week period in 2022. RESULT: A total of 345 individual responses were received from 15 countries with majorities of respondent from United Kingdom (n = 245, 71%) and Denmark (n = 66, 19%). Mean age was 41.9 (S.D 9.8), similar for females, 42.5 (S.D 9.0) and men 40.9 years (S.D 9.7). Most reporting radiographers worked in public hospitals (90%). The vast majority of the respondents (n = 270, n = 94%) authored and signed their own clinical reports while a minority (n = 18, 6%) stated that their reports were checked by radiologists. CONCLUSION: The survey highlights the scope of practice of reporting radiographers working in Europe. Reporting is becoming a career path for an increasing number of radiographers across Europe and there is assess to academic education and clinical support. IMPLICATION FOR PRACTICE: Reporting radiographers fulfil an important role within the current demands of healthcare. This demand is likely to increase in the future, and therefore it is vital that there is some form of standardisation in the level of education that this group of healthcare professionals receive.

How to set up a mobile X-ray unit in the community - Implementation initiatives for patient-centred care.

BACKGROUND: Mobile X-ray unit have previously been widely used within hospitals in general, predominately for imaging patients admitted to intensive care units or for patients who cannot tolerate a visit to the radiology department. It is now possible to have an X-ray examination outside the hospital in nursing homes or to bring the service to frail, vulnerable or disabled patients. A visit to the hospital can be a frightening experience for vulnerable patients living with dementia or other neurological disorder. It can potentially have a long-term impact on the patient's recovery or behaviour. This technical note aimed to provide insight into the planning and running of a mobile X-ray unit in a Danish setting. METHODS: This technical note draws on the lived experiences of radiographers operating and managing a mobile X-ray service, sharing experiences with the implementation process and the challenges and successes of a mobile X-ray unit. RESULTS AND KEY FINDINGS: Successes include that frail patient, especially those with dementia, benefit from mobile X-ray examinations, as they can remain in familiar surroundings during an X-ray procedure. In general, patients experienced an increased quality of life and less need for sedation medication due to anxiety. Also, working within a mobile X-ray unit is meaningful work for radiographers. Challenges included increased physicality of work, the funding required for the mobile unit, planning a communication strategy to the referring general practitioners, and permission from authorities to perform mobile examinations. CONCLUSION: We have successfully implemented a mobile radiography unit that provides a better service for vulnerable patients through learning from successes and challenges. IMPLICATIONS FOR PRACTICE: The mobile radiography setup can benefit vulnerable patients and provide meaningful work for the radiographers. However, transportation of mobile radiography equipment outside the hospital includes many considerations and challenges.

What motivates radiographers to start working with research?

INTRODUCTION: This study aimed to investigate the motivation and barriers of clinical radiographers to work with research in a Danish clinical setting. METHODS: The project was designed as a mixed method explorative study, including survey and focus group interviews. A paper based survey was distributed to clinical radiographers, with a bachelor's degree (few with a diploma in Radiography), at three departments of radiology. The survey collected data on motivation, challenges, and barriers in relation to research in clinical practice. Thematic analyses were performed according to the nature of the survey and used to categorize statements. The focus group interview included five managing radiographers (3 with a bachelor's degree) who formed part of the clinical management at their respective departments. RESULTS: The survey resulted in 39 responses with an overall response rate of 56%. The majority of clinical radiographers were female (69%, n = 27) and 12 were male.Most radiographers (77%, n = 30) reported interest in research projects and 89% of them (n = 27) found it difficult to dedicate time to research projects next to the clinical work. CONCLUSION: The study increases the understanding of the motivation and current barriers to start working with research in clinical settings including dependent and independent projects. Clinical radiographers reported to have interest in research. Improvements should focus on department culture, skills, and management support. Clinical Radiographers can be motivated when the departments offer training and support, the projects are relevant to clinical practice and research working hours are provided. IMPLICATIONS FOR PRACTICE: The study offers an insight into current perspectives and obstacles for clinical radiographers in relation to research. The literature on the perception and interest in research by clinical radiographers and managers is limited and further investigation of the field is warranted.

Radiographers' individual perspectives on sonography - A survey of European Federation of Radiographer Societies (EFRS).

INTRODUCTION: Radiographers can elect to work within many different modalities, one being ultrasound. Within Europe there are differing opinions about how much of a role radiographers should take in relation to the ultrasound examination, particularly report writing. This paper provides findings exploring the radiographer's views on working within sonography. METHODS: In 2019 an electronic survey was disseminated to radiographer members by European Federation of Radiographer Societies (EFRS) national radiographer societies, following a pilot study. A mix of closed questions, free text, and scale responses aimed to investigate radiographers' practice, legal responsibilities, report writing, educational level and experiences of support and mentoring. RESULTS: Of 561 radiographers participating, most (92%) reported performing ultrasound scans. Challenges with legislation, medical protectionism and lack of high-quality education restricted other radiographers. On average, the respondents have practiced ultrasound for 13.5 years. A total of 60% had postgraduate education and carried out a wide range of examinations. A full interpretative report, including advice on further investigations is performed by 52%, whilst 22% provide a checklist or descriptive report. Over 55% of radiographers took legal responsibility for the examination and the majority had clear protocols, good mentoring and support in the workplace. Peer review of their work was less common. CONCLUSION: The result shows that in 21 (n = 25) countries radiographers perform ultrasound, however not without challenges. Educational levels range from no formal education or short courses to an MSc in ultrasound. Report writing practice differs across the EFRS countries responding to the survey, as does peer review to enhance skills and clinical practice. IMPLICATIONS FOR PRACTICE: National Radiographer societies could review findings to support campaigning for a change in legislation and improvements to educational offerings in ultrasound.

Radiographers in ultrasound: Motivation and role expansion. A survey of European Federation of Radiographer Societies (EFRS).

INTRODUCTION: Variability in non-medical ultrasound practice across Europe has been highlighted in studies. Meanwhile, advanced practice in radiography has undergone rapid development in the United Kingdom (UK). This survey aimed to review results relating to extended role and advanced practice skills, motivation and job satisfaction from a wider survey of radiographers undertaking ultrasound examinations across the European Federation of Radiographer Societies' (EFRS) community. METHODS: Following a pilot study, a SurveyMonkey™ on-line questionnaire was disseminated to EFRS member societies to share with their members, and via social media platforms. Quantitative questions for this article related to extended and advanced practice skills, communication of results, job satisfaction, motivation and career development. Theme analysis was used to assess qualitative feedback concerning priorities for future developments within the ultrasound role. RESULTS: There were 561 responses, mainly from the UK, Ireland and Spain (81%). The majority (83.4%) of UK sonographers communicate findings to patients, compared with 27.1% in other EFRS countries. More engage with teaching (UK = 90.1%, non-UK 72.9%) compared with activities in the other advanced practice domains. The lowest involvement was the research domain, with only 33% actively involved in research. Radiographers were motivated to undertake ultrasound to develop their knowledge and skills and assume more responsibility. CONCLUSION: Wide variations in ultrasound practice were seen across respondent countries. Generally, radiographers are happy with their ultrasound roles, although priorities include legislation for the sonographer role, remuneration, respect or support from medical colleagues, high quality education and role progression opportunities. IMPLICATIONS FOR PRACTICE: The findings provide a better understanding of radiographer views which can assist radiographer societies and local teams to develop strategies to enhance advanced practice skills development and career prospects in ultrasound.

The role of radiographers in ultrasound: A survey of the national societies within the European Federation of Radiographer Societies (EFRS).

INTRODUCTION: Ultrasound is one of many areas of specialism for radiographers to develop their skills in. As part of a wider suite of surveys, the European Federation of Radiographer Societies (EFRS) wanted to investigate the extent and scope of practice for radiographers practising ultrasound across Europe. This report details the results of the initial survey, exploring the views of the EFRS countries' National Radiographer Societies. METHODS: An electronic survey was sent to representatives of the 43 national radiographer societies who were members of the EFRS. Questions asked about radiographer practice in ultrasound within individual countries, scope of the role, particularly report writing, in addition to investigating current ultrasound education, barriers and opinions on priorities for radiographer ultrasound practice. RESULTS: Forty individual responses were received, from a total of 27 countries, covering 62.8% of the EFRS member societies invited to participate. Radiologists or specialised medical practitioners performed ultrasound in the majority of countries. Radiographers practise ultrasound in 48% of countries and 11% have some limited involvement in ultrasound. Countries without radiographer engagement in ultrasound reported legislative issues or lack of acceptance from the medical professions (52%) and/or limited specific ultrasound education (39%) as predominant factors. In most countries where radiographers practise ultrasound, clinical reporting is a descriptive report or checklist approved by a medical doctor/radiologist. CONCLUSION: The results highlight the scope of practice and barriers faced in some EFRS countries to enabling radiographers to develop their skills and competencies in ultrasound. IMPLICATIONS FOR PRACTICE: Priorities for radiographer societies to assist in the development of ultrasound as a pathway for radiographer progression in countries, where it is not yet available, include education programmes, acceptance by medical professionals and changes to legislation.

Acute recurrent bradycardia with evoked potential loss during transforaminal lumbar interbody fusion.

During a transforaminal lumbar interbody fusion a patient experienced acute intermittent bradycardia with manipulation of the intervertebral body space, followed by loss of somatosensory evoked potentials that did not recover. Postoperative evaluation revealed new bilateral lower extremity sensory and motor deficits. We postulate an afferent reflex arc to explain this and other reported instances of bradycardia and asystole during transforaminal lumbar interbody fusion surgery. Awareness of the association between bradycardia during lumbar spine surgery may alert anaesthetists, surgeons and neuromonitoring teams to impending neurological harm.

Music and pain during endorectal ultrasonography examination: A prospective questionnaire study and literature review.

INTRODUCTION: Music interventions have been recognized as a method to reduce pain during medical procedures, but within medical imaging the subject has received little attention. Endorectal ultrasonography examination is in some patients associated with anxiety and pain, and since in Denmark pain relief is usually not administered by the Department of Radiology, it is important to find effective alternative methods to help patients manage their pain during imaging procedures. The primary aim of this study was to evaluate the effect of music on self-reported pain during endorectal examination of rectal cancer patients. METHODS: A prospective questionnaire study of patients undergoing endorectal ultrasonography was conducted. Patients were randomized into two groups: a music group (n = 66), and non-music group (n = 60). Standard endorectal ultrasonography was performed in all patients. Pain was self-assessed using a Visual Analogue Scale ranging from 0 to 10, with 0 representing "no pain" and 10 maximum pain. RESULTS: A total of 126 patients were included in the study, 81 (64.3%) men and 45 (35.7%) women. The demographics were similar in the two groups. The mean pain score during endorectal ultrasonography in the music and non-music group was 1.95 and 2.30, (p = 0.404). CONCLUSION: In this randomized study music did not significantly affect the pain level experienced by the patients. Endorectal ultrasound was not entirely painless but less painful than colonoscopy (Visual Analogue Scale 2.1 and 3.8, respectively). IMPLICATIONS FOR PRACTICE: Health care professionals may consider using music during painful procedures.

Characteristics of symptomatic men with testicular microlithiasis - A Danish cross-sectional questionnaire study.

Testicular microlithiasis (TML) is an incidental finding at ultrasonography of the scrotum. A link between testicular microlithiasis and testicular cancer has been suggested. However, the majority of studies are retrospective using ultrasonography with minor data on health status and life style characteristics. Our objective was to investigate if lifestyle and health are associated with TML. In 2014, we conducted a self-administered questionnaire survey including 1538 men, who all due to testicular/scrotal symptoms had an ultrasound investigation of the scrotum during 2004-2013. The men were divided into men with TML and men without. The 23-items questionnaire included items on age, height, weight, lifestyle (alcohol consumptions, smoking habits, workload, exercise and food), previous diseases in the testicles, pain and consumption of analgesics. The prevalence of TML was 12.8%. Overall, lifestyle factors did not vary between men with or without TML. However, men with TML did consume more crisp than men without. Development of TML was not associated to classic life style factors such as alcohol consumption, smoking habits, or mothers smoking during pregnancy. Also, age and height could not be linked to presence of TML. We did find, however, that men with TML experienced less physical activity and consumed more crisp than men without TML. Since ingestion of crisps has potential carcinogenic effect (acrylamide), this finding needs confirmation in a separate study.

Testicular Microlithiasis: Patient Compliance in a Two-Year Follow-Up Program.

Introduction: We present a retrospective 2-year follow-up cohort of 103 men with testicular microlithiasis (TML) and discuss patient compliance and the value of surveillance. Methods: A retrospective analysis of patients examined with scrotal ultrasonography (US) in the period from 2008 through 2010 was performed. A total of 103 men with TML were diagnosed and offered US follow-up every 6 months for 2 years. They were retrospectively analyzed regarding demographics and follow-up details, including the development of any kind of malignancy until March 2015, using the Danish Electronic Pathology Registry. Results: The prevalence of TML was 10.3%. Of the 103 men with TML, 23 (22.3%) had TML in the left testicle, 38 (36.9%) in the right (p=0.002), and 42 (40.8%) had bilateral TML. Patient compliance was low with 11.7% participating in all US follow-up examinations. 5 men presented risk factors (testicular atrophy (N=1) and previous testicular cancer (N=4)), but no cases of testicular malignancy were found in the follow-up period. Conclusion: The low patient compliance conflicts with the ESUR Scrotal Imaging Subcommittee guidelines that recommend scrotal US follow-up annually for TML until the age of 55 years. The fact that no cancers were found during follow-up using the pathology registry calls the value of follow-up into question.

Lipopolysaccharide in concentrations above 40 ng/ml stimulates proliferation of the IL-6-dependent B9 cell line.

The B9 assay is known to be a specific and sensitive assay for the estimation of interleukin-6 activity. This assay was found to be compromised by lipopolysaccharide in concentrations > or = 40 ng lipopolysaccharide per ml. The lipopolysaccharide stimulates proliferation of the B9 cell line in a dose-dependent manner both when measuring the proliferation by thymidine incorporation and when using the MTT assay. However the LPS dose-response curve is different compared to the dose-response curve for IL-6. A sample containing 100 ng LPS/ml but no IL-6 would be estimated erroneously to contain 12 pg IL-6. The interference of lipopolysaccharide is totally abolished by the addition of polymyxin B to the samples but the addition has no effect on the IL-6 induced proliferation.

Detection of lipopolysaccharide in the picogram range of tissue culture media by a kinetic chromogenic Limulus amebocyte lysate assay.

A kinetic chromogenic Limulus amebocyte lysate assay for detection of lipopolysaccharide in the picogram range is described. The kinetic Limulus assay was used to detect lipopolysaccharide in a tissue culture media containing interfering low-molecular-weight substances. The interfering substances were removed by ultrafiltration. The recovery of lipopolysaccharide from the ultrafiltrated tissue culture media was 61.6 +/- 21.4%. The kinetic Limulus assay was compared with the traditional end-point chromogenic Limulus assay. The results in the two assays showed a good correlation. The detection limit was 1 pg/ml in the chromogenic assay and 0.25 pg/ml in the kinetic assay.