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Ahlqvist, Jan
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Publications (10 of 40) Show all publications
Gustafsson, N., Ahlqvist, J. & Levring Jäghagen, E. (2019). Long-term skill improvement among general dental practitioners after a short training programme in diagnosing calcified carotid artery atheromas on panoramic radiographs. European journal of dental education, 23, 54-61
Open this publication in new window or tab >>Long-term skill improvement among general dental practitioners after a short training programme in diagnosing calcified carotid artery atheromas on panoramic radiographs
2019 (English)In: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 23, p. 54-61Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To study general dental practitioners (GDPs) ability to detect calcified carotid artery atheromas (CCAAs) in panoramic radiographs (PRs) and if their diagnostic accuracy in long term is improved after a short training programme.

METHODS: Fourteen GDPs had their diagnostic accuracy regarding CCAA in PR assessed at baseline, 2 weeks and 1 year after training. Comparison was made with a reference standard based on consensus results from two experienced oral and maxillofacial radiologists. At each session, 100 radiographs were assessed individually by the GDPs. After the baseline assessment, the GDPs participated in a 2-hour training programme comprising a lecture and diagnostic training by calibration. The GDPs results before and after training were compared, as well as between follow-up sessions.

RESULTS: A significant improvement in diagnostic accuracy was observed with increased sensitivity (from 41.8% to 55.7%, P = 0.02) without a significant decrease in specificity (from 87.2% to 86.7%, P = 0.87). The Kappa values also increased (from 0.66 to 0.71, P = 0.04). At 1-year follow-up, the improvement compared to baseline remained significant. There were no significant changes between the 2-week and 1-year follow-up assessment.

CONCLUSION: A short training programme can significantly and sustainable improve GDPs diagnostic accuracy regarding CCAA.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
calcified carotid artery atheroma, carotid artery calcification, education, panoramic radiography, radiology
National Category
Dentistry
Research subject
Radiology; Odontology; education
Identifiers
urn:nbn:se:umu:diva-153768 (URN)10.1111/eje.12402 (DOI)000455041100015 ()30358024 (PubMedID)2-s2.0-85056352070 (Scopus ID)
Available from: 2018-12-01 Created: 2018-12-01 Last updated: 2019-05-20Bibliographically approved
Gustafsson, N., Ahlqvist, J. B., Näslund, U., Wester, P., Buhlin, K., Gustafsson, A. & Levring Jäghagen, E. (2018). Calcified carotid artery atheromas in panoramic radiographs are associated with a first myocardial infarction: a case-control study. Oral surgery, oral medicine, oral pathology and oral radiology, 125(2), 199-205
Open this publication in new window or tab >>Calcified carotid artery atheromas in panoramic radiographs are associated with a first myocardial infarction: a case-control study
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2018 (English)In: Oral surgery, oral medicine, oral pathology and oral radiology, ISSN 2212-4403, E-ISSN 2212-4411, Vol. 125, no 2, p. 199-205Article in journal (Refereed) Published
Abstract [en]

Objective. The aim of this case-control study was to investigate whether patients with a first myocardial infarction (MI) had a higher prevalence of calcified carotid artery atheromas (CCAAs) on panoramic radiographs (PRs) than age-, gender-, and residential area-matched controls without MI. Study Design. Six hundred ninety-six cases with a first MI and 696 controls were included in this substudy of the Swedish multicentre PAROKRANK study. All participants underwent panoramic radiography, and the PRs were evaluated for CCAAs. Results. The prevalence of CCAAs detected by PR was 33.8% (235 of 696) in cases and 27.6% (192 of 696) in controls (odds ratio [OR] 1.24; 95% confidence interval [CI] 1.04-1.44; P = .012). Among males, 32.7% of cases (184 of 562) and 26.5% of controls (149 of 562) displayed CCAAs on PRs (OR 1.24; 95% CI 1.03-1.48; P = .022). Among both genders, bilateral CCAAs were significantly more common among cases than among controls (P = .002). Conclusions. Cases with recent MIs had a significantly higher prevalence of CCAAs on PRs compared with controls without MIs. This difference between groups was more pronounced for bilateral CCAAs. These findings supported the hypothesis that CCAA detection could serve as a risk indicator for future MIs.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC, 2018
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-144341 (URN)10.1016/j.oooo.2017.10.009 (DOI)000422751700018 ()29242130 (PubMedID)
Available from: 2018-02-08 Created: 2018-02-08 Last updated: 2019-05-21Bibliographically approved
Garoff, M., Ahlqvist, J., Levring Jäghagen, E., Johansson, E. & Wester, P. (2016). Carotid calcification in panoramic radiographs: radiographic appearance and the degree of carotid stenosis. Dento-Maxillo-Facial Radiology, 45(6), Article ID 20160147.
Open this publication in new window or tab >>Carotid calcification in panoramic radiographs: radiographic appearance and the degree of carotid stenosis
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2016 (English)In: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 45, no 6, article id 20160147Article in journal (Refereed) Published
Abstract [en]

Objectives: Approximately 7% of patients examined with panoramic radiographs (PRs) for odontological reasons, and with incidental findings of carotid artery calcification (CAC), have significant (≥50%) carotid stenosis (SCS). The aim of this study was to determine if the radiographic appearance of CACs in PRs could be categorized such that we could improve the positive-predictive value (PPV) for SCS detection.

Methods: This cross-sectional study included 278 patients with CACs identified by PRs, 127 with SCS and 151 without SCS. CACs were categorized based on the following appearances: (1) single, (2) scattered or (3) vessel-outlining. Correlates were derived for each category according to positivity or not for SCS in the corresponding neck sides. For a representative adult population (in dentistry) presenting with CACs in PRs, PPVs for SCS prediction were then calculated for three subgroups based on different combinations of appearances (2) and/or (3).

Results: Vessel-outlining CACs corresponded to 65% of neck sides with SCS vs 47% without SCS (p < 0.001). Single CACs corresponded to 15% of neck sides with SCS vs 27% without SCS (p = 0.006). Scattered CACs corresponded to 20% of neck sides with SCS vs 26% without SCS (p  = 0.127). In the representative population, the PPVs for SCS detection were comparable (7.2–7.8%) for all three subgroups and when the presence of a CAC is the sole criterion (7.4%).

Conclusions: Stratifying the radiographic appearance of CACs in PRs does not improve the PPV for SCS detection. Whether different radiographic appearances are associated with future risk of stroke, or other cardiovascular events, remains unknown.

Place, publisher, year, edition, pages
British Institute of Radiology, 2016
Keywords
carotid stenosis, panoramic radiography, calcification
National Category
Dentistry Radiology, Nuclear Medicine and Medical Imaging
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-119791 (URN)10.1259/dmfr.20160147 (DOI)000381711400003 ()
Note

First published in theses in manuscript form.

Available from: 2016-04-27 Created: 2016-04-27 Last updated: 2018-06-07Bibliographically approved
Johansson, J., Bladh, M., Sjöström, M. & Ahlqvist, J. (2016). The use of intraoral radiographs for identification of edentulous patients rehabilitated with implants. Journal of Forensic Odonto-Stomatology, 34(1), 1-9
Open this publication in new window or tab >>The use of intraoral radiographs for identification of edentulous patients rehabilitated with implants
2016 (English)In: Journal of Forensic Odonto-Stomatology, ISSN 0258-414X, E-ISSN 2219-6749, Vol. 34, no 1, p. 1-9Article in journal (Refereed) Published
Abstract [en]

The aims of this study were; i) to determine the accuracy by which two intra-oral radiographic examinations performed on patients with edentulous mandibles treated with dental implants can be matched. ii) to determine whether prosthodontic supra-construction is important for matching. iii) to investigate whether there is a difference between oral and maxilla-facial radiologists (OMR) and dental practitioners, not specialized in oral and maxillofacial radiology (NOMR), regarding their ability to match. The specific features of the radiographs used by the operators to acquire a match were also investigated. Intra-oral radiographic examinations from 59 patients were utilized. Radiographic examinations from 47 patients carried out at placement of the supra-construction and at subsequent follow-up examinations were used as "ante-mortem" and "post-mortem" records respectively. Examinations from 12 patients were added to the "post-mortem" records without "ante-mortem" records being available. The study was divided into two parts. In Part One all "ante"- and "post-mortem" records had the supra-construction masked and in Part Two it was visible. Seven dentists (4 OMR, 3 NOMR) were instructed to specify on what basis each matching was made on the confidence of a three-graded scale OMR had 93.2 % and 98.5 % accuracy in Parts One and Two respectively. NOMR had 63.8 % and 87.9 %. Bone anatomy was the most commonly used feature by OMR to obtain a match. For NOMR it was the appearance of the fixtures. OMR reported higher confidence in their ability to match the examinations. This study indicates that OMR could be a valuable resource in cases of identification where dental implants are a feature of the post-mortem dental records.

Keywords
dental identification, forensic odontology, dental implants, intra-oral radiographs, edentulous patients
National Category
Forensic Science
Research subject
Forensic Medicine; Odontology; Radiology
Identifiers
urn:nbn:se:umu:diva-125216 (URN)
Available from: 2016-09-08 Created: 2016-09-08 Last updated: 2018-06-07Bibliographically approved
Jashari, F., Ibrahimi, P., Johansson, E., Ahlqvist, J., Arnerlöv, C., Garoff, M., . . . Henein, M. Y. (2015). Atherosclerotic Calcification Detection: A Comparative Study of Carotid Ultrasound and Cone Beam CT. International Journal of Molecular Sciences, 16(8), 19978-19988
Open this publication in new window or tab >>Atherosclerotic Calcification Detection: A Comparative Study of Carotid Ultrasound and Cone Beam CT
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2015 (English)In: International Journal of Molecular Sciences, ISSN 1422-0067, E-ISSN 1422-0067, Vol. 16, no 8, p. 19978-19988Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND AIM: Arterial calcification is often detected on ultrasound examination but its diagnostic accuracy is not well validated. The aim of this study was to determine the accuracy of carotid ultrasound B mode findings in detecting atherosclerotic calcification quantified by cone beam computed tomography (CBCT).

METHODS: We analyzed 94 carotid arteries, from 88 patients (mean age 70 ± 7 years, 33% females), who underwent pre-endarterectomy ultrasound examination. Plaques with high echogenic nodules and posterior shadowing were considered calcified. After surgery, the excised plaques were examined using CBCT, from which the calcification volume (mm3) was calculated. In cases with multiple calcifications the largest calcification nodule volume was used to represent the plaque. Carotid artery calcification by the two imaging techniques was compared using conventional correlations.

RESULTS: Carotid ultrasound was highly accurate in detecting the presence of calcification; with a sensitivity of 88.2%. Based on the quartile ranges of calcification volumes measured by CBCT we have divided plaque calcification into four groups: <8; 8-35; 36-70 and >70 mm3. Calcification volumes ≥8 were accurately detectable by ultrasound with a sensitivity of 96%. Of the 21 plaques with <8 mm3 calcification volume; only 13 were detected by ultrasound; resulting in a sensitivity of 62%. There was no difference in the volume of calcification between symptomatic and asymptomatic patients.

CONCLUSION: Carotid ultrasound is highly accurate in detecting the presence of calcified atherosclerotic lesions of volume ≥8 mm3; but less accurate in detecting smaller volume calcified plaques. Further development of ultrasound techniques should allow better detection of early arterial calcification.

Place, publisher, year, edition, pages
MDPI, 2015
Keywords
carotid atherosclerosis, ultrasound, calcification
National Category
Cardiac and Cardiovascular Systems Dentistry Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy) Radiology, Nuclear Medicine and Medical Imaging
Research subject
Medicine, cardiovascular disease; Odontology; Radiology
Identifiers
urn:nbn:se:umu:diva-107990 (URN)10.3390/ijms160819978 (DOI)000366826100173 ()26307978 (PubMedID)
Available from: 2015-08-31 Created: 2015-08-31 Last updated: 2018-06-07Bibliographically approved
Garoff, M., Johansson, E., Ahlqvist, J., Arnerlöv, C., Levring Jäghagen, E. & Wester, P. (2015). Calcium quantity in carotid plaques: detection in panoramic radiographs and association with degree of stenosis. Oral surgery, oral medicine, oral pathology and oral radiology, 120(2), 269-274
Open this publication in new window or tab >>Calcium quantity in carotid plaques: detection in panoramic radiographs and association with degree of stenosis
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2015 (English)In: Oral surgery, oral medicine, oral pathology and oral radiology, ISSN 2212-4403, E-ISSN 2212-4411, Vol. 120, no 2, p. 269-274Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To determine calcium volume in extirpated carotid plaques, analyze correlations between calcium volume and degree of stenosis, and analyze whether calcium volume influences the possibility of detecting stenosis in panoramic radiographs.

STUDY DESIGN: Ninety-seven consecutive patients with ultrasonography-verified carotid stenosis were examined with panoramic radiography before surgery. Extirpated carotid plaques (n = 103) were analyzed for calcium volume by cone beam computed tomography (CBCT). Panoramic radiographs were analyzed for carotid calcifications.

RESULTS: The median calcium volume was 45 mm(3) (first quartile subtracted from the third quartile [IQR], 14-98 mm(3)). We observed no correlation between calcium volume and degree of stenosis. Seventy-eight stenoses were situated within the region included in the panoramic radiographs, and their volumes ranged from 0 to 509 mm(3). Of these, 99% revealed carotid calcifications on panoramic radiographs.

CONCLUSIONS: We found no association between calcium volume and degree of carotid stenosis. Calcium volume did not influence the possibility of detecting carotid calcifications in panoramic radiographs.

National Category
Dentistry Radiology, Nuclear Medicine and Medical Imaging
Research subject
Odontology; Radiology; Medicine, cardiovascular disease
Identifiers
urn:nbn:se:umu:diva-107590 (URN)10.1016/j.oooo.2015.04.010 (DOI)000360302600022 ()26166031 (PubMedID)
Available from: 2015-08-25 Created: 2015-08-24 Last updated: 2018-06-07Bibliographically approved
Johansson, E., Ahlqvist, J., Garoff, M., Levring Jäghagen, E., Meimermondt, A. & Wester, P. (2015). Carotid calcifications on panoramic radiographs: a 5-year follow-up study. Oral surgery, oral medicine, oral pathology and oral radiology, 120(4), 513-520
Open this publication in new window or tab >>Carotid calcifications on panoramic radiographs: a 5-year follow-up study
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2015 (English)In: Oral surgery, oral medicine, oral pathology and oral radiology, ISSN 2212-4403, E-ISSN 2212-4411, Vol. 120, no 4, p. 513-520Article in journal (Refereed) Published
Abstract [en]

Objective. The aim of this study was to determine whether people with calcifications in the area of the carotid arteries on panoramic radiographs (CALPANs) have an increased prevalence of vascular risk factors or an increased risk of future vascular events. Materials and Methods. We included 113 consecutive patients with CALPANs and 116 gender- and age-matched controls without CALPANs. Vascular risk factors were generally known in the study population, since it was recorded in a population-based community-screening program. Results. Patients with CALPANs had a higher prevalence of vascular risk factors than controls independent of previous vascular events. During the 5.4-year follow-up, patients with CALPANs had a higher risk of a combined endpoint of vascular events (5.6%/yr) compared with the controls (2.4%/yr) (P = .004 by log rank test; unadjusted hazard ratio (HR) 2.4; 95% CI 1.3-4.3). This difference was not significant when previous vascular events and risk factors were taken into account (adjusted HR; 1.2; 95% CI 0.6-2.3; P = .62; Cox regression). Conclusions. People with CALPANs are very likely to have vascular risk factors, but these factors might be unknown when CALPANs are detected. Accordingly, patients with CALPANs should be advised to have their vascular risk factors regularly checked in order to receive advice on preventive lifestyle modifications and medical treatment when indicated. However, it remains unknown whether CALPANs add information about the independent risk of future vascular events. Therefore, further studies are warranted to investigate whether the detection of CALPANs indicates a need for additional or more intense vascular treatment.

Place, publisher, year, edition, pages
[Johansson, Elias; Meimermondt, Amanda] Umea Univ, Dept Pharmacol & Clin Neurosci, S-90182 ea, Sweden. [Johansson, Elias; Wester, Per] Umea Univ, Dept Publ Hlth & Clin Med, S-90182 Umea, Sweden. [Ahlqvist, Jan; Garoff, Maria; Jaghagen, Eva Levring] Umea Univ, Dept Odontol, S-90182 Umea, Sweden.: , 2015
Keywords
vascular risk, cardiology
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-109796 (URN)10.1016/j.oooo.2015.06.026 (DOI)000360912000015 ()26260766 (PubMedID)
Available from: 2015-10-08 Created: 2015-10-06 Last updated: 2018-06-07Bibliographically approved
Söderström, T., Häll, L. O., Nilsson, T. & Ahlqvist, J. (2015). Computer Simulation Training in Health Care Education: Fuelling Reflection-in-Action?. Journal Simulation & Gaming, 45(6), 805-828
Open this publication in new window or tab >>Computer Simulation Training in Health Care Education: Fuelling Reflection-in-Action?
2015 (English)In: Journal Simulation & Gaming, ISSN 1046-8781, E-ISSN 1552-826X, Vol. 45, no 6, p. 805-828Article in journal (Refereed) Published
Abstract [en]

Background Drawing on Donald Schön’s concepts, this article investigates the links between computer simulation training and the concepts of reflection-on-action and reflection-in-action while participating in dental and nursing trainingAim This article explores how collaborative simulation training and collaborative conventional training affect students’ reflection processes when learning to interpret radiographic images.Method This qualitative study uses interviews from 11 nursing and 18 dental students to compare the experiences of conventional training (CON-dental students) with intra-oral radiography simulation (SIM-dental students) and cervical spine simulation training (nursing students).Results The analysis showed that the simulation and conventional training influenced reflective thought processes in different ways. The SIM students concentrated on the visual information before and after they made their choices, whereas the CON students, in the absence of three-dimensional characters and reference points, focused on discussions and mutual agreements within the group to achieve a solution. The visual feedback and opportunities for manipulation provided by the simulation training encouraged the SIM-students to examine their assumptions and actions (to reflect-in-action) while solving the task. Prior knowledge served as a theoretical and methodological scheme guiding the learners’ actions and directed their reflection on their existing anatomical knowledge.Conclusions SIM and CON training provide different conditions for students’ reflective thought processes, and these differences influence how well the groups learn radiological principles.

Place, publisher, year, edition, pages
Sage Publications, 2015
Keywords
cervical spine simulator, collaborative learning, computer simulation training, experiential learning, health care education, higher education, intra-oral knowing-in-action, peer-group adjustment, prior knowledge, radiography simulation, reflection- in-action, reflection-on-action, reflective learning, three-dimensional visualization, virtual microscopy
National Category
Pedagogy
Identifiers
urn:nbn:se:umu:diva-101201 (URN)10.1177/1046878115574027 (DOI)
Available from: 2015-03-24 Created: 2015-03-24 Last updated: 2018-06-07Bibliographically approved
Ibrahimi, P., Jashari, F., Ahlqvist, J., Arnerlöv, C., Garoff, M., Johansson, E., . . . Henein, M. Y. (2014). Carotid ultrasound accurately detects arterial calcification quantified by cone beam computed tomography. Paper presented at Congress of the European-Society-of-Cardiology (ESC), AUG 30-SEP 03, 2014, Barcelona, SPAIN. European Heart Journal, 35(Supplement 1, Meeting abstract P3519), 636-636
Open this publication in new window or tab >>Carotid ultrasound accurately detects arterial calcification quantified by cone beam computed tomography
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2014 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 35, no Supplement 1, Meeting abstract P3519, p. 636-636Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2014
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-97257 (URN)000343001303463 ()
Conference
Congress of the European-Society-of-Cardiology (ESC), AUG 30-SEP 03, 2014, Barcelona, SPAIN
Available from: 2014-12-15 Created: 2014-12-12 Last updated: 2018-06-07Bibliographically approved
Garoff, M., Johansson, E., Ahlqvist, J., Levring Jäghagen, E., Arnerlöv, C. & Wester, P. (2014). Detection of calcifications in panoramic radiographs in patients with carotid stenoses ≥50%. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 117(3), 385-391
Open this publication in new window or tab >>Detection of calcifications in panoramic radiographs in patients with carotid stenoses ≥50%
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2014 (English)In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 117, no 3, p. 385-391Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Carotid stenoses ≥50% are associated with increased risk for stroke that can be reduced by prophylactic carotid endarterectomy (CEA). Calcifications in arteries can be detected in panoramic radiographs (PRs). In a cross-sectional study, we analyzed (1) extirpated plaques for calcification, (2) how often PRs disclosed calcified plaques, (3) how often patients with stenoses ≥50% presented calcifications in PRs, and (4) the additional value of frontal radiographs (FRs).

STUDY DESIGN: Patients (n = 100) with carotid stenosis ≥50% were examined with PRs and FRs before CEA. Extirpated carotid plaques were radiographically examined (n = 101).

RESULTS: It was found that 100 of 101 (99%) extirpated plaques were calcified, of which 75 of 100 (75%) were detected in PRs; 84 of 100 (84%) patients presented carotid calcifications in the PRs, in 9.5% contralateral to the stenosis ≥50%.

CONCLUSIONS: Carotid calcifications are seen in PRs in 84% of patients with carotid stenosis ≥50%, independent of gender. FRs do not contribute significantly to this identification.

Place, publisher, year, edition, pages
Elsevier, 2014
National Category
Clinical Medicine Dentistry
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-86143 (URN)10.1016/j.oooo.2014.01.010 (DOI)000331062700029 ()24528796 (PubMedID)
Available from: 2014-02-18 Created: 2014-02-18 Last updated: 2018-06-08Bibliographically approved
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