| 1. |
- Antonenko, Kateryna, et al.
(författare)
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Sex-related differences in risk factors, type of treatment received and outcomes in patients with atrial fibrillation and acute stroke: Results from the RAF-study (Early Recurrence and Cerebral Bleeding in Patients with Acute Ischemic Stroke and Atrial Fibrillation)
- 2017
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Ingår i: European Stroke Journal. - : SAGE Publications. - 2396-9873 .- 2396-9881. ; 2:1, s. 46-53
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Atrial fibrillation is an independent risk factor of thromboembolism. Women with atrial fibrillation are at a higher overall risk for stroke compared to men with atrial fibrillation. The aim of this study was to evaluate for sex differences in patients with acute stroke and atrial fibrillation, regarding risk factors, treatments received and outcomes. Methods: Data were analyzed from the ‘‘Recurrence and Cerebral Bleeding in Patients with Acute Ischemic Stroke and Atrial Fibrillation’’ (RAF-study), a prospective, multicenter, international study including only patients with acute stroke and atrial fibrillation. Patients were followed up for 90 days. Disability was measured by the modified Rankin Scale (0–2 favorable outcome, 3–6 unfavorable outcome). Results: Of the 1029 patients enrolled, 561 were women (54.5%) (p<0.001) and younger (p<0.001) compared to men. In patients with known atrial fibrillation, women were less likely to receive oral anticoagulants before index stroke (p¼0.026) and were less likely to receive anticoagulants after stroke (71.3% versus 78.4%, p¼0.01). There was no observed sex difference regarding the time of starting anticoagulant therapy between the two groups (6.4�11.7 days for men versus 6.5�12.4 days for women, p¼0.902). Men presented with more severe strokes at onset (mean NIHSS 9.2�6.9 versus 8.1�7.5, p<0.001). Within 90 days, 46 (8.2%) recurrent ischemic events (stroke/TIA/systemic embolism) and 19 (3.4%) symptomatic cerebral bleedings were found in women compared to 30 (6.4%) and 18 (3.8%) in men (p¼0.28 and p¼0.74). At 90 days, 57.7% of women were disabled or deceased, compared to 41.1% of the men (p<0.001). Multivariate analysis did not confirm this significance. Conclusions: Women with atrial fibrillation were less likely to receive oral anticoagulants prior to and after stroke compared to men with atrial fibrillation, and when stroke occurred, regardless of the fact that in our study women were younger and with less severe stroke, outcomes did not differ between the sexes.
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| 2. |
- Calamida, Annalisa, et al.
(författare)
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The Not so Simple Stellar System ω Cen. II. Evidence in Support of a Merging Scenario
- 2020
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Ingår i: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 891:2
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Tidskriftsartikel (refereegranskat)abstract
- We present multiband photometry covering ∼5° × 5° across ω Cen collected with the Dark Energy Camera on the 4 m Blanco telescope, combined with Hubble Space Telescope and Wide Field Imager data for the central regions. The unprecedented photometric accuracy and field coverage allows us to confirm the different spatial distribution of blue and red main-sequence stars, and of red giant branch (RGB) stars with different metallicities. The ratio of the number of blue to red main-sequence stars shows that the blue main-sequence stellar subpopulation has a more extended spatial distribution compared to the red main-sequence one, with the frequency of blue main-sequence stars increasing at a distance of ∼20′ from ω Cen's center. Similarly, the more metal-rich RGB stars show a more extended spatial distribution compared to the more metal-poor ones in the outskirts of the cluster. Moreover, the centers of the distributions of metal-rich and metal-poor RGB stars are shifted in different directions with respect to the geometrical center of ω Cen. We constructed stellar density profiles for the blue and red main-sequence stars; they show that the blue main-sequence stellar subpopulation has a more extended spatial distribution compared to the red main-sequence one in the outskirts of ω Cen, confirming the results based on the number ratio. We also computed the ellipticity profile of ω Cen, which has a maximum value of 0.16 at a distance of ∼8′ from the center, and a minimum of 0.05 at ∼30′; the average ellipticity is ∼0.10. The circumstantial evidence presented in this work suggests a merging scenario for the formation of the peculiar stellar system ω Cen.
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| 3. |
- Flexeder, Claudia, et al.
(författare)
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Second-hand smoke exposure in adulthood and lower respiratory health during 20 year follow up in the European Community Respiratory Health Survey
- 2019
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Ingår i: Respiratory Research. - : BioMed Central. - 1465-9921 .- 1465-993X. ; 20
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Tidskriftsartikel (refereegranskat)abstract
- Early life exposure to tobacco smoke has been extensively studied but the role of second-hand smoke (SHS) for new-onset respiratory symptoms and lung function decline in adulthood has not been widely investigated in longitudinal studies. Our aim is to investigate the associations of exposure to SHS in adults with respiratory symptoms, respiratory conditions and lung function over 20 years. We used information from 3011 adults from 26 centres in 12 countries who participated in the European Community Respiratory Health Surveys I-III and were never or former smokers at all three surveys. Associations of SHS exposure with respiratory health (asthma symptom score, asthma, chronic bronchitis, COPD) were analysed using generalised linear mixed-effects models adjusted for confounding factors (including sex, age, smoking status, socioeconomic status and allergic sensitisation). Linear mixed-effects models with additional adjustment for height were used to assess the relationships between SHS exposure and lung function levels and decline. Reported exposure to SHS decreased in all 26 study centres over time. The prevalence of SHS exposure was 38.7% at baseline (1990-1994) and 7.1% after the 20-year follow-up (2008-2011). On average 2.4% of the study participants were not exposed at the first, but were exposed at the third examination. An increase in SHS exposure over time was associated with doctor-diagnosed asthma (odds ratio (OR): 2.7; 95% confidence interval (95%-CI): 1.2-5.9), chronic bronchitis (OR: 4.8; 95%-CI: 1.6-15.0), asthma symptom score (count ratio (CR): 1.9; 95%-CI: 1.2-2.9) and dyspnoea (OR: 2.7; 95%-CI: 1.1-6.7) compared to never exposed to SHS. Associations between increase in SHS exposure and incidence of COPD (OR: 2.0; 95%-CI: 0.6-6.0) or lung function (beta: - 49 ml; 95%-CI: -132, 35 for FEV1 and beta: - 62 ml; 95%-CI: -165, 40 for FVC) were not apparent. Exposure to second-hand smoke may lead to respiratory symptoms, but this is not accompanied by lung function changes.
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| 4. |
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| 5. |
- Götschi, Thomas, et al.
(författare)
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Elemental composition and reflectance of ambient fine particles at 21 European locations
- 2005
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Ingår i: Atmospheric Environment. - Oxford : Pergamon Press. - 1352-2310 .- 1873-2844. ; 39:32, s. 5947-5958
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Tidskriftsartikel (refereegranskat)abstract
- We sampled fine particles (PM2.5) over a 1-year period at 21 central urban monitoring sites in 20 cities of the European Community Respiratory Health Survey (ECRHS). Particle filters were then analysed for elemental composition using energy dispersive X-ray fluorescence spectrometry and reflectance (light absorption). Elemental analyses yielded valid results for 15 elements (Al, As, Br, Ca, Cl, Cu, Fe, K, Mn, Pb, S, Si, Ti, V, Zn). Annual and seasonal means Of PM2.5, reflectance, and elements show a wide range across Europe with the lowest levels found in Iceland and up to 80 times higher concentrations in Northern Italy. This pattern holds for most of the air pollution indicators. The mass concentration of S did constitute the largest fraction of the analysed elements Of PM2.5 in all locations. The crustal component varies from less than 10% up to 25% across these cities. Temporal correlations of daily values vary considerably from city to city, depending on the indicators compared. Nevertheless, correlations between estimates of long-term exposure, such as annual means, are generally high among indicators Of PM2.5 from anthropogenic sources, such as S, metals, and reflectance. This highlights the difficulty to disentangle effects of specific sources or PM constituents in future health effect analyses using annual averages.
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| 6. |
- Menzies, Scott W, et al.
(författare)
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Dermoscopic evaluation of amelanotic and hypomelanotic melanoma.
- 2008
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Ingår i: Archives of dermatology. - : American Medical Association (AMA). - 1538-3652 .- 0003-987X. ; 144:9, s. 1120-7
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Tidskriftsartikel (refereegranskat)abstract
- To determine the predictive dermoscopic features of amelanotic and hypomelanotic melanoma.
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| 7. |
- Menzies, Scott W, et al.
(författare)
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Dermoscopic Evaluation of Nodular Melanoma.
- 2013
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Ingår i: JAMA dermatology (Chicago, Ill.). - : American Medical Association (AMA). - 2168-6084 .- 2168-6068. ; 149:6, s. 699-709
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Nodular melanoma (NM) is a rapidly progressing potentially lethal skin tumor for which early diagnosis is critical. OBJECTIVE To determine the dermoscopy features of NM. DESIGN Eighty-three cases of NM, 134 of invasive non-NM, 115 of nodular benign melanocytic tumors, and 135 of nodular nonmelanocytic tumors were scored for dermoscopy features using modified and previously described methods. Lesions were separated into amelanotic/hypomelanotic or pigmented to assess outcomes. SETTING Predominantly hospital-based clinics from 5 continents. MAIN OUTCOME MEASURES Sensitivity, specificity, and odds ratios for features/models for the diagnosis of melanoma. RESULTS Nodular melanoma occurred more frequently as amelanotic/hypomelanotic (37.3%) than did invasive non-NM (7.5%). Pigmented NM had a more frequent (compared with invasive non-NM; in descending order of odds ratio) symmetrical pigmentation pattern (5.8% vs 0.8%), large-diameter vessels, areas of homogeneous blue pigmentation, symmetrical shape, predominant peripheral vessels, blue-white veil, pink color, black color, and milky red/pink areas. Pigmented NM less frequently displayed an atypical broadened network, pigment network or pseudonetwork, multiple blue-gray dots, scarlike depigmentation, irregularly distributed and sized brown dots and globules, tan color, irregularly shaped depigmentation, and irregularly distributed and sized dots and globules of any color. The most important positive correlating features of pigmented NM vs nodular nonmelanoma were peripheral black dots/globules, multiple brown dots, irregular black dots/globules, blue-white veil, homogeneous blue pigmentation, 5 to 6 colors, and black color. A model to classify a lesion as melanocytic gave a high sensitivity (>98.0%) for both nodular pigmented and nonnodular pigmented melanoma but a lower sensitivity for amelanotic/hypomelanotic NM (84%). A method for diagnosing amelanotic/hypomelanotic malignant lesions (including basal cell carcinoma) gave a 93% sensitivity and 70% specificity for NM. CONCLUSIONS AND RELEVANCE When a progressively growing, symmetrically patterned melanocytic nodule is identified, NM needs to be excluded.
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| 8. |
- Paciaroni, Maurizio, et al.
(författare)
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Early recurrence in paroxysmal versus sustained atrial fibrillation in patients with acute ischaemic stroke.
- 2019
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Ingår i: European stroke journal. - : SAGE Publications. - 2396-9881 .- 2396-9873. ; 4:1, s. 55-64
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Tidskriftsartikel (refereegranskat)abstract
- The relationship between different patterns of atrial fibrillation and early recurrence after an acute ischaemic stroke is unclear.In a prospective cohort study, we evaluated the rates of early ischaemic recurrence after an acute ischaemic stroke in patients with paroxysmal atrial fibrillation or sustained atrial fibrillation which included persistent and permanent atrial fibrillation.In patients with acute ischaemic stroke, atrial fibrillation was categorised as paroxysmal atrial fibrillation or sustained atrial fibrillation. Ischaemic recurrences were the composite of ischaemic stroke, transient ischaemic attack and symptomatic systemic embolism occurring within 90 days from acute index stroke.A total of 2150 patients (1155 females, 53.7%) were enrolled: 930 (43.3%) had paroxysmal atrial fibrillation and 1220 (56.7%) sustained atrial fibrillation. During the 90-day follow-up, 111 ischaemic recurrences were observed in 107 patients: 31 in patients with paroxysmal atrial fibrillation (3.3%) and 76 with sustained atrial fibrillation (6.2%) (hazard ratio (HR) 1.86 (95% CI 1.24-2.81)). Patients with sustained atrial fibrillation were on average older, more likely to have diabetes mellitus, hypertension, history of stroke/ transient ischaemic attack, congestive heart failure, atrial enlargement, high baseline NIHSS-score and implanted pacemaker. After adjustment by Cox proportional hazard model, sustained atrial fibrillation was not associated with early ischaemic recurrences (adjusted HR 1.23 (95% CI 0.74-2.04)).After acute ischaemic stroke, patients with sustained atrial fibrillation had a higher rate of early ischaemic recurrence than patients with paroxysmal atrial fibrillation. After adjustment for relevant risk factors, sustained atrial fibrillation was not associated with a significantly higher risk of recurrence, thus suggesting that the risk profile associated with atrial fibrillation, rather than its pattern, is determinant for recurrence.
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| 9. |
- Pesce, Giancarlo, et al.
(författare)
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Time and age trends in smoking cessation in Europe
- 2019
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 14:2
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Tidskriftsartikel (refereegranskat)abstract
- Background Smoking is the main risk factor for most of the leading causes of death. Cessation is the single most important step that smokers can take to improve their health. With the aim of informing policy makers about decisions on future tobacco control strategies, we estimated time and age trends in smoking cessation in Europe between 1980 and 2010. Methods Data on the smoking history of 50,228 lifetime smokers from 17 European countries were obtained from six large population-based studies included in the Ageing Lungs in European Cohorts (ALEC) consortium. Smoking cessation rates were assessed retrospectively, and age trends were estimated for three decades (1980-1989, 1990-1999, 2000-2010). The analyses were stratified by sex and region (North, East, South, West Europe). Results Overall, 21,735 subjects (43.3%) quit smoking over a total time-at-risk of 803,031 years. Cessation rates increased between 1980 and 2010 in young adults (16-40 years), especially females, from all the regions, and in older adults (41-60 years) from North Europe, while they were stable in older adults from East, South and West Europe. In the 2000s, the cessation rates for men and women combined were highest in North Europe (49.9 per 1,000/ year) compared to the other regions (range: 26.5-32.7 per 1,000/ year). A sharp peak in rates was observed for women around the age of 30, possibly as a consequence of pregnancy-related smoking cessation. In most regions, subjects who started smoking before the age of 16 were less likely to quit than those who started later. Conclusions Our findings suggest an increasing awareness on the detrimental effects of smoking across Europe. However, East, South and West European countries are lagging behind North Europe, suggesting the need to intensify tobacco control strategies in these regions. Additional efforts should be made to keep young adolescents away from taking up smoking, as early initiation could make quitting more challenging during later life.
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| 10. |
- Piotto, Giampaolo, et al.
(författare)
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Relative Frequencies of Blue Stragglers in Galactic Globular Clusters: Constraints for the Formation Mechanisms
- 2004
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Ingår i: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 604:2, s. 109-112
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Tidskriftsartikel (refereegranskat)abstract
- We discuss the main properties of the Galactic globular cluster (GC)blue straggler stars (BSSs), as inferred from our new catalog containingnearly 3000 BSSs. The catalog has been extracted from thephotometrically homogeneous V versus (B-V) color-magnitude diagrams(CMDs) of 56 GCs, based on Wide Field Planetary Camera 2 images of theircentral cores. In our analysis, we used consistent relative distancesbased on the same photometry and calibration. The number of BSSs hasbeen normalized to obtain relative frequencies (FBSS) andspecific densities (NS) using different stellar populationsextracted from the CMD. The cluster FBSS is significantlysmaller than the relative frequency of field BSSs. We find a significantanticorrelation between the BSS relative frequency in a cluster and itstotal absolute luminosity (mass). There is no statistically significanttrend between the BSS frequency and the expected collision rate. Thevalue of FBSS does not depend on other cluster parameters,apart from a mild dependence on the central density. Post-core-collapseclusters act like normal clusters as far as the BSS frequency isconcerned. We also show that the BSS luminosity function for the mostluminous clusters is significantly different, with a brighter peak andextending to brighter luminosities than in the less luminous clusters.These results imply that the efficiency of BSS production mechanisms andtheir relative importance vary with the cluster mass.Based on observations with the NASA/ESA Hubble Space Telescope, obtainedat the Space Telescope Science Institute, which is operated by theAssociation of Universities for Research in Astronomy, Inc., under NASAcontract NAS 5-26555.
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