| 1. |
|
|
| 2. |
|
|
| 3. |
- Ederle, Joerg, et al.
(författare)
-
Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial
- 2010
-
Ingår i: The Lancet. - 1474-547X. ; 375:9719, s. 985-997
-
Tidskriftsartikel (refereegranskat)abstract
- Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. Findings The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4.0%) events of disabling stroke or death in the stenting group compared with 27 (3.2%) events in the endarterectomy group (hazard ratio [HR] 1.28, 95% CI 0.77-2.11). The incidence of stroke, death, or procedural myocardial infarction was 8.5% in the stenting group compared with 5.2% in the endarterectomy group (72 vs 44 events; HR 1.69, 1.16-2.45, p=0.006), Risks of any stroke (65 vs 35 events; HR 1.92, 1.27-2.89) and all-cause death (19 vs seven events; HR 2.76, 1.16-6.56) were higher in the stenting group than in the endarterectomy group. Three procedural myocardial infarctions were recorded in the stenting group, all of which were fatal, compared with four, all non-fatal, in the endarterectomy group. There was one event of cranial nerve palsy in the stenting group compared with 45 in the endarterectomy group. There were also fewer haematomas of any severity in the stenting group than in the endarterectomy group (31 vs 50 events; p=0.0197). Interpretation Completion of long-term follow-up is needed to establish the efficacy of carotid artery stenting compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for patients suitable for surgery.
|
|
| 4. |
- Ng, M Y M, et al.
(författare)
-
Meta-analysis of 32 genome-wide linkage studies of schizophrenia
- 2009
-
Ingår i: Molecular Psychiatry. - : Springer Science and Business Media LLC. - 1359-4184 .- 1476-5578. ; 14:8, s. 774-785
-
Tidskriftsartikel (refereegranskat)abstract
- A genome scan meta-analysis (GSMA) was carried out on 32 independent genome-wide linkage scan analyses that included 3255 pedigrees with 7413 genotyped cases affected with schizophrenia (SCZ) or related disorders. The primary GSMA divided the autosomes into 120 bins, rank-ordered the bins within each study according to the most positive linkage result in each bin, summed these ranks (weighted for study size) for each bin across studies and determined the empirical probability of a given summed rank (P(SR)) by simulation. Suggestive evidence for linkage was observed in two single bins, on chromosomes 5q (142-168 Mb) and 2q (103-134 Mb). Genome-wide evidence for linkage was detected on chromosome 2q (119-152 Mb) when bin boundaries were shifted to the middle of the previous bins. The primary analysis met empirical criteria for 'aggregate' genome-wide significance, indicating that some or all of 10 bins are likely to contain loci linked to SCZ, including regions of chromosomes 1, 2q, 3q, 4q, 5q, 8p and 10q. In a secondary analysis of 22 studies of European-ancestry samples, suggestive evidence for linkage was observed on chromosome 8p (16-33 Mb). Although the newer genome-wide association methodology has greater power to detect weak associations to single common DNA sequence variants, linkage analysis can detect diverse genetic effects that segregate in families, including multiple rare variants within one locus or several weakly associated loci in the same region. Therefore, the regions supported by this meta-analysis deserve close attention in future studies.
|
|
| 5. |
- Sator, Lea, et al.
(författare)
-
Overdiagnosis of COPD in Subjects With Unobstructed Spirometry A BOLD Analysis
- 2019
-
Ingår i: Chest. - : Elsevier BV. - 0012-3692 .- 1931-3543. ; 156:2, s. 277-288
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries participating in the BOLD Study between 2003 and 2012.METHODS: A false positive diagnosis of COPD was considered when participants reported a doctor's diagnosis of COPD, but postbronchodilator spirometry was unobstructed (FEV1/FVC > LLN). Additional analyses were performed using the fixed ratio criterion (FEV1/FVC < 0.7).RESULTS: Among 16,177 participants, 919 (5.7%) reported a previous medical diagnosis of COPD. Postbronchodilator spirometry was unobstructed in 569 subjects (61.9%): false positive COPD. A similar rate of overdiagnosis was seen when using the fixed ratio criterion (55.3%). In a subgroup analysis excluding participants who reported a diagnosis of "chronic bronchitis" or "emphysema" (n = 220), 37.7% had no airflow limitation. The site-specific prevalence of false positive COPD varied greatly, from 1.9% in low- to middle-income countries to 4.9% in high-income countries. In multivariate analysis, overdiagnosis was more common among women, and was associated with higher education; former and current smoking; the presence of wheeze, cough, and phlegm; and concomitant medical diagnosis of asthma or heart disease. Among the subjects with false positive COPD, 45.7% reported current use of respiratory medication. Excluding patients with reported asthma, 34.4% of those with normal spirometry still used a respiratory medication.CONCLUSIONS: False positive COPD is frequent. This might expose nonobstructed subjects to possible adverse effects of respiratory medication.
|
|
| 6. |
- Studnicka, Michael, et al.
(författare)
-
COPD : Should Diagnosis Match Physiology?
- 2020
-
Ingår i: Chest. - : Elsevier BV. - 0012-3692 .- 1931-3543. ; 157:2, s. 473-475
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 7. |
- Baumeister, J., et al.
(författare)
-
Brain Activity in Predictive Sensorimotor Control for Landings: an EEG Pilot Study
- 2013
-
Ingår i: International Journal of Sports Medicine. - : Georg Thieme Verlag KG. - 0172-4622 .- 1439-3964. ; 34:12, s. 1106-1111
-
Tidskriftsartikel (refereegranskat)abstract
- Landing from a jump is related to predictive sensorimotor control. Frontal, central and parietal brain areas are known to play a role in this process based on online sensory feedback. This can be measured by EEG. However, there is only limited knowledge about brain activity during predictive preparation for drop landings (DL). The purpose is to demonstrate changes in brain activity in preparation for DL in different conditions. After resting, 10 athletes performed a series of DLs and were asked to concentrate on the landing preparation for 10s before an auditory signal required them to drop land from a 30cm platform. This task was executed before and after a standardized fatigue protocol. EEG spectral power was calculated during DL preparation. Frontal Theta power was increased during preparation compared to rest. Parietal Alpha-2 power demonstrated higher values in preparation after fatigue condition while lower limb kinematics remained unchanged. Cortical activity in frontal and parietal brain areas is sensitive for predictive sensorimotor control of drop landings. Frontal Theta power demonstrates an increase and is related to higher attentional control. In a fatigued condition the parietal Alpha-2 power increase might be related to a deactivation in the somatosensory brain areas.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- de Louw, P. G. B., et al.
(författare)
-
Quantifying water and salt fluxes in a lowland polder catchment dominated by boil seepage : a probabilistic end-member mixing approach
- 2011
-
Ingår i: Hydrology and Earth System Sciences. - : Copernicus GmbH. - 1027-5606 .- 1607-7938. ; 15, s. 2101-2117
-
Tidskriftsartikel (refereegranskat)abstract
- Upward saline groundwater seepage is leading to surface water salinization of deep lying polders in the Netherlands. Identifying measures to reduce the salt content requires a thorough understanding and quantification of the dominant sources of water and salt on a daily basis. However, as in most balance studies, there are large uncertainties in the contribution from groundwater seepage. Taking these into account, we applied a probabilistic (GLUE) end-member mixing approach to simulate two years of daily to weekly observations of discharge, salt loads and salt concentration of water pumped out of an artificially drained polder catchment area. We were then able to assess the contribution from the different sources to the water and salt balance of the polder and uncertainties in their quantification. Our modelling approach demonstrates the need to distinguish preferential from diffuse seepage. Preferential seepage via boils contributes, on average, 66% to the total salt load and only about 15% to the total water flux into the polder and therefore forms the main salinization pathway. With the model we were able to calculate the effect of future changes on surface water salinity and to assess the uncertainty in our predictions. Furthermore, we analyzed the parameter sensitivity and uncertainty to determine for which parameter the quality of field measurements should be improved to reduce model input and output uncertainty. High frequency measurements of polder water discharge and weighted concentration at the outlet of the catchment area appear to be essential for obtaining reliable simulations of water and salt fluxes and for allotting these to the different sources.
|
|
