| 1. |
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| 2. |
- Van Hemelrijck, Mieke, et al.
(författare)
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Reasons for Discontinuing Active Surveillance : Assessment of 21 Centres in 12 Countries in the Movember GAP3 Consortium
- 2019
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Ingår i: European Urology. - : Elsevier BV. - 0302-2838. ; 75:3, s. 523-531
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Tidskriftsartikel (refereegranskat)abstract
- Background: Careful assessment of the reasons for discontinuation of active surveillance (AS) is required for men with prostate cancer (PCa). Objective: Using Movember's Global Action Plan Prostate Cancer Active Surveillance initiative (GAP3) database, we report on reasons for AS discontinuation. Design, setting, and participants: We compared data from 10 296 men on AS from 21 centres across 12 countries. Outcome measurements and statistical analysis: Cumulative incidence methods were used to estimate the cumulative incidence rates of AS discontinuation. Results and limitations: During 5-yr follow-up, 27.5% (95% confidence interval [CI]: 26.4–28.6%) men showed signs of disease progression, 12.8% (95% CI: 12.0–13.6%) converted to active treatment without evidence of progression, 1.7% (95% CI: 1.5–2.0%) continued to watchful waiting, and 1.7% (95% CI: 1.4–2.1%) died from other causes. Of the 7049 men who remained on AS, 2339 had follow-up for >5 yr, 4561 had follow-up for <5 yr, and 149 were lost to follow-up. Cumulative incidence of progression was 27.5% (95% CI: 26.4–28.6%) at 5 yr and 38.2% (95% CI: 36.7–39.9%) at 10 yr. A limitation is that not all centres were included due to limited information on the reason for discontinuation and limited follow-up. Conclusions: Our descriptive analyses of current AS practices worldwide showed that 43.6% of men drop out of AS during 5-yr follow-up, mainly due to signs of disease progression. Improvements in selection tools for AS are thus needed to correctly allocate men with PCa to AS, which will also reduce discontinuation due to conversion to active treatment without evidence of disease progression. Patient summary: Our assessment of a worldwide database of men with prostate cancer (PCa) on active surveillance (AS) shows that 43.6% drop out of AS within 5 yr, mainly due to signs of disease progression. Better tools are needed to select and monitor men with PCa as part of AS.
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| 3. |
- Clark, Andrew G., et al.
(författare)
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Evolution of genes and genomes on the Drosophila phylogeny
- 2007
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 450:7167, s. 203-218
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Tidskriftsartikel (refereegranskat)abstract
- Comparative analysis of multiple genomes in a phylogenetic framework dramatically improves the precision and sensitivity of evolutionary inference, producing more robust results than single-genome analyses can provide. The genomes of 12 Drosophila species, ten of which are presented here for the first time (sechellia, simulans, yakuba, erecta, ananassae, persimilis, willistoni, mojavensis, virilis and grimshawi), illustrate how rates and patterns of sequence divergence across taxa can illuminate evolutionary processes on a genomic scale. These genome sequences augment the formidable genetic tools that have made Drosophila melanogaster a pre-eminent model for animal genetics, and will further catalyse fundamental research on mechanisms of development, cell biology, genetics, disease, neurobiology, behaviour, physiology and evolution. Despite remarkable similarities among these Drosophila species, we identified many putatively non-neutral changes in protein-coding genes, non-coding RNA genes, and cis-regulatory regions. These may prove to underlie differences in the ecology and behaviour of these diverse species.
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| 7. |
- Adams, M, et al.
(författare)
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Preventive strategies and factors associated with surgically treated necrotising enterocolitis in extremely preterm infants: an international unit survey linked with retrospective cohort data analysis
- 2019
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 9:10, s. e031086-
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Tidskriftsartikel (refereegranskat)abstract
- To compare necrotising enterocolitis (NEC) prevention practices and NEC associated factors between units from eight countries of the International Network for Evaluation of Outcomes of Neonates, and to assess their association with surgical NEC rates.DesignProspective unit-level survey combined with retrospective cohort study.SettingNeonatal intensive care units in Australia/New Zealand, Canada, Finland, Israel, Spain, Sweden, Switzerland and Tuscany (Italy).PatientsExtremely preterm infants born between 240to 286weeks’ gestation, with birth weights<1500 g, and admitted between 2014–2015.ExposuresNEC prevention practices (probiotics, feeding, donor milk) using responses of an on-line pre-piloted questionnaire containing 10 questions and factors associated with NEC in literature (antenatal steroids, c-section, indomethacin treated patent ductus arteriosus and sepsis) using cohort data.Outcome measuresSurgical NEC rates and death following NEC using cohort data.ResultsThe survey response rate was 91% (153 units). Both probiotic provision and donor milk availability varied between 0%–100% among networks whereas feeding initiation and advancement rates were similar in most networks. The 9792 infants included in the cohort study to link survey results and cohort outcomes, revealed similar baseline characteristics but considerable differences in factors associated with NEC between networks. 397 (4.1%) neonates underwent NEC surgery, ranging from 2.4%–8.4% between networks. Standardised ratios for surgical NEC were lower for Australia/New Zealand, higher for Spain, and comparable for the remaining six networks.ConclusionsThe variation in implementation of NEC prevention practices and in factors associated with NEC in literature could not be associated with the variation in surgical NEC incidence. This corroborates the current lack of consensus surrounding the use of preventive strategies for NEC and emphasises the need for research.
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| 8. |
- Argenbright, Christine, et al.
(författare)
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Embracing diversity : measuring the impact of an international immersion learning experience on nursing students' cultural beliefs and values
- 2022
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Ingår i: International Journal of Nursing Education Scholarship. - : Walter de Gruyter. - 1548-923X .- 2194-5772. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: An international Nursing Leadership Collaborative covened in Japan to hold a patient safety and quality workshop for nursing students from six countries. The purpose was to measure students' self reported beliefs reflecting sensitivity and openness to cultural diversity before and after the international experience.METHODS: A pre-post-test design was used and the Beliefs, Events, and Values Inventory was administered to international undergraduate and graduate nursing students.RESULTS: The group aggregate data analysis indicate that prior to the start of the workshop, the group presented itself as quite introspective and after the workshop the group reported being more sophisticated in making causal explanations about why the world works in the way it does.CONCLUSIONS: Nursing students experienced an expanded awareness of their beliefs and values that reflect a greater degree of intercultural sensitivity for acceptance of inclusivity and diversity after the experience.
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| 9. |
- Argenbright, Christine, et al.
(författare)
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Making a Difference : Changing Nursing Students’ Global Beliefs
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: In August of 2017, the Nursing Leadership Collaborative of the International Network of Universities (INU), convened in Hiroshima, Japan to hold a patient safety and quality of care workshop for nursing students from six INU universities located in Japan, Spain, Sweden, South Africa, United Kingdom and the United States. The workshop, held during Peace Week, had as its purpose to develop a model of international collaboration and education to impact quality and safety education in nursing. In addition to examining the impact of the experience on student learning, the leaders wished to determine to what degree students’ beliefs and values changed due to participation in the nursing collaborative workshop. The purpose of this research was to measure students’ self-reported beliefs that reflect global competency and openness to cultural diversity. Methods: IRB approval was obtained and a pre-post-test mixed method design was used with the convenience sample of 21 English speaking international undergraduate and graduate nursing students. The workshop lasted 9 days and included a curriculum based on the Quality and Safety Education for Nurses (QSEN) Competencies. Experiential clinical activities focused on how patient safety is improved in Japan. Cultural activities were integrated and primarily focused on the Peace Week events which included the Peace Day ceremony to memorialize the dropping of the atomic bomb on Hiroshima. The Beliefs, Events, and Values Inventory (BEVI), a mixed methods measure, was administered and used to asses relevant processes and constructs including (but not limited to); openness; receptivity to different cultures; stereotyping; self and emotional awareness; and strategies for making sense of why people do what they do. (Shealy, 2017). This study examines Time 1 (prior to participation in the program) and Time 2 (immediately after the completion of the program). Students also completed daily reflections in response to prompts provided by faculty. Qualitative data analysis was completed using NVivo software. Results: Results from the group aggregate data analysis indicate that prior to the start of the program (Time 1) this group presents itself as quite introspective (Self-awareness = 75thpercentile); midway between confident and inquisitive in terms of understanding who others are, how world works, and their experience of life (Basic Determinism = 41st percentile); quite open to and interested in cultural beliefs and practices that are different from one’s own (Sociocultural Openness = 74th percentile); open to non-traditional gender roles (Gender Traditionalism = 20th percentile); do not have strong religious convictions (Religious Traditionalism = 26th percentile); and express a high degree of concern about ecological issues and the natural world (Ecological Resonance = 59th percentile). Following the completion of the program (Time 2), the group as a whole reported being more sophisticated in making causal explanations about why the world works in the way it does (Basic Determinism = 30th percentile); increased openness to and interest in cultural beliefs and practices that are different from one’s own (Sociocultural Openness = 80th percentile); increased openness to non-traditional gender roles (Gender Traditionalism = 13th percentile); further decrease in strong religious convictions (Religious Traditionalism = 20th percentile); and increased degree of concern about ecological issues and the natural world (Ecological Resonance = 71stpercentile). Statements from qualitative data analysis reflect greater understanding and empathy for others’ perspectives and experiences and increased openness. Conclusion: Nursing students experienced changes in their beliefs and values that reflect a greater degree of global competency after the short term international workshop experience with other nursing students.
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| 10. |
- Beltempo, Marc, et al.
(författare)
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Respiratory Management of Extremely Preterm Infants : An International Survey
- 2018
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Ingår i: Neonatology. - : S. Karger AG. - 1661-7800 .- 1661-7819. ; 114:1, s. 28-36
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There are significant international variations in chronic lung disease rates among very preterm infants yet there is little data on international variations in respiratory strategies.OBJECTIVE: To evaluate practice variations in the respiratory management of extremely preterm infants born at < 29 weeks' gestational age (GA) among 10 neonatal networks participating in the International Network for Evaluating Outcomes (iNeo) of Neonates collaboration.METHODS: A web-based survey was sent to the representatives of 390 neonatal intensive care units from Australia/New Zealand, Canada, Finland, Illinois (USA), Israel, Japan, Spain, Sweden, Switzerland, and Tuscany (Italy). Responses were based on practices in 2015.RESULTS: Overall, 321 of the 390 units responded (82%). The majority of units within networks (40-92%) mechanically ventilate infants born at 23-24 weeks' GA on continuous positive airway pressure (CPAP) with 30-39% oxygen in respiratory distress within 48 h after birth, but the proportion of units that offer mechanical ventilation for infants born at 25-26 weeks' GA at similar settings varied significantly (20-85% of units within networks). The most common respiratory strategy for infants born at 27-28 weeks' GA on CPAP with 30-39% oxygen with respiratory distress within 48 h after birth used by units also varied significantly among networks: mechanical ventilation (0-60%), CPAP (3-82%), intubation and surfactant administration with immediate extubation (0-75%), and less invasive surfactant administration (0-68%).CONCLUSIONS: There are marked variations but also similarities in respiratory management of extremely preterm infants between networks. Further collaboration and exploration is needed to better understand the association of these variations in practice with pulmonary outcomes.
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| 11. |
- Bengtsson, Mariette, et al.
(författare)
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Göra skillnad : förändra sjuksköterskestudenters kliniska och globala kompetens
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: I augusti 2017 genomförde Nursing Leadership Collaborative of the International Network of Universities (INU) en workshop i Hiroshima, Japan med temat Patient Safety and Quality Care. Workshoppen som varade i nio dagar avsåg att utveckla en modell för internationellt samarbete och utbildning i syfte att stärka patientsäkerhet och kvalitetsförbättringsfrågor utifrån ett globalt perspektiv. Utbildningen baserades på ett koncept utarbetat inom ramen för The Quality and Safety Education for Nurses (QSEN) som utgick från sjuksköterskans kärnkompetenser. Undervisningen i form av teori, praktik och studiebesök, varvades med kulturella aktiviteter som bland annat inkluderade fredsceremoni till minne av atombomben som släpptes över Hiroshima den 4 augusti 1945, ”The A-bomb day”. Undervisningen leddes av INU medlemmar som alla är experter i ämnet Syftet med workshopen och tillhörande utvärdering och forskning var att undersöka om sjuksköterskestudenters kliniska kompetens ökar genom att delta i internationell workshop samt om deras självrapporterade övertygelser som speglar global kompetens och öppenhet mot kulturell mångfald förändrades. Det är viktigt att värdera resultat och effekter av all undervisning och lärande, speciellt internationella projekt som genererar fler resurser än traditionell undervisning på hemma universitetet. Metod: Deltagare i workshopen var 21 sjuksköterskestudenter från sex INU-anslutna universitet, Japan, Spanien, Sverige, Syd Afrika, Storbritannien och USA. Innan workshopen började och i anslutning till att workshopen avslutades svarade studenterna på olika kunskapsfrågor på innehåll som togs upp under workshopen (för- och eftertest). Studenterna svarade också på enkäten Beliefs, Events, and Values Inventory (BEVI) vid samma tillfälle samt 6 månader senare. Studenterna skrev även dagliga reflektioner kring undervisningen och sina övriga upplevelser. Analys baserad på denna kvalitativ data kommer att genomföras med stöd av NVivo-programvara. Resultat: All data har ännu inte analyserats men preliminära resultat visar på att sjuksköterskestudenterna hade förbättrat sin kliniska kompetens kring patientsäkerhet och förbättringsarbete efter att ha deltagit i workshopen. Resultatet speglar en större förståelse och empati för andras perspektiv och erfarenheter och ökad öppenhet mot andra synsätt och kulturer. Som grupp visade analysen av BEVI på att deltagarna hade skaffat sig en ökad förståelse för varför världen fungerar på det sätt som den gör och deras var bekymmer för ekologiska världsproblem hade ökat. Resultatet visade även på en ökad öppenhet mot och intresse för andra kulturella övertygelser och praxis som skiljer sig från sin egen sociokulturell miljö och på en ökad öppenhet gentemot icke-traditionella könsroller. Arbetet med den internationella kursen var en utmaning även om det fanns en samsyn om innehållet. Det fanns kulturella skillnader avseende pedagogik och arbetssätt. Slutsats: Förutom att öka sin kliniska kompetens genom att delta i en internationell workshop upplevde sjuksköterskestudenterna förändringar i sina övertygelser och värderingar som speglar en större grad av global kompetens. Detta är en viktig kompetens för det livslånga lärandet i dagens och morgondagens mångfaldssamhälle oavsett om studenten praktiserar sitt yrke på hemorten eller i ett nationellt sammanhang. Internationella sammarbeten främjar också lärarens pedagogiska kompetens.
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| 12. |
- Berglund, Erik, et al.
(författare)
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Functional role of the Ca2+-activated Cl- channel DOG1/TMEM16A in gastrointestinal stromal tumor cells
- 2014
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Ingår i: Experimental Cell Research. - : Elsevier BV. - 0014-4827 .- 1090-2422. ; 326:2, s. 315-325
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Tidskriftsartikel (refereegranskat)abstract
- DOG1, a Ca2+-activated Cl- channel (CaCC), was identified in 2004 to be robustly expressed in gastrointestinal stromal tumors (GIST). It was rapidly included as a tumor marker in routine diagnostics, but the functional role remained unknown. CaCCs are important regulators of normal physiological functions, but also implicated in tumorigenesis, cancer progression, metastasis, cell migration, apoptosis, proliferation and viability in several malignancies. We therefore investigated whether DOG1 plays a role in the three latter in GIST by utilizing in vitro cell model systems. Confocal microscopy identified different subcellular localizations of DOG1 in imatinib-sensitive and imatinib-resistant cells. Electrophysiological studies confirmed that DOG1-specific pharmacological agents possess potent activating and inhibiting properties. Proliferation assays showed small effects up to 72 h, and flow cytometric analysis of adherent cells with 7-AAD/Annexin V detected no pharmacological effects on viable GIST cells. However, inhibition of DOG1 conveyed pro-apoptotic effects among early apoptotic imatinib-resistant cells. In conclusion, DOG1 generates Cl- currents in GIST that can be regulated pharmacologically, with small effects on cell viability and proliferation in vitro. Inhibition of DOG1 might act pro-apoptotic on some early apoptotic GIST cell populations. Further studies are warranted to fully illuminate the function of DOG1 and its potential as therapeutic target.
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| 13. |
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| 15. |
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| 16. |
- Caramuta, S., et al.
(författare)
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Role of microRNAs and microRNA machinery in the pathogenesis of diffuse large B-cell lymphoma
- 2013
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Ingår i: Blood Cancer Journal. - : Springer Science and Business Media LLC. - 2044-5385. ; 3, s. e152-
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Tidskriftsartikel (refereegranskat)abstract
- Deregulation of microRNA (miRNA) expression has been documented in diffuse large B-cell lymphoma (DLBCL). However, the impact of miRNAs and their machinery in DLBCL is not fully determined. Here, we assessed the role of miRNA expression and their processing genes in DLBCL development. Using microarray and RT-qPCR approaches, we quantified global miRNAs and core components of miRNA-processing genes expression in 75 DLBCLs (56 de novo and 19 transformed) and 10 lymph nodes (LN). Differential miRNA signatures were identified between DLBCLs and LNs, or between the de novo and transformed DLBCLs. We also identified subsets of miRNAs associated with germinal center B-cell phenotype, BCL6 and IRF4 expression, and clinical staging. In addition, we showed a significant over-expression of TARBP2 in de novo DLBCLs as compared with LNs, and decreased expression of DROSHA, DICER, TARBP2 and PACT in transformed as compared with de novo cases. Interestingly, cases with high TARBP2 and DROSHA expression had a poorer chemotherapy response. We further showed that TARBP2 can regulate miRNA-processing efficiency in DLBCLs, and its expression inhibition decreases cell growth and increases apoptosis in DLBCL cell lines. Our findings provide new insights for the understanding of miRNAs and its machinery in DLBCL.
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| 17. |
- Darlow, Brian A, et al.
(författare)
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International variations and trends in the treatment for retinopathy of prematurity
- 2017
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Ingår i: British Journal of Ophthalmology. - : BMJ Publishing Group Ltd. - 0007-1161 .- 1468-2079. ; 101:10, s. 1399-1404
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the rates of retinopathy of prematurity (ROP) and treatment of ROP by laser or intravitreal anti-vascular endothelial growth factor among preterm neonates from high-income countries participating in the International Network for Evaluating Outcomes (iNeo) of neonates.METHODS: weeks' gestation who were admitted to neonatal units in Australia/New Zealand, Canada, Finland, Israel, Japan, Spain, Sweden, Switzerland, Tuscany (Italy) and the UK between 2007 and 2013. Pairwise comparisons of ROP treatment in survivors between countries were evaluated by Poisson and multivariable logistic regression analyses after adjustment for confounders. A composite outcome of death or ROP treatment was compared between countries using logistic regression and standardised ratios.RESULTS: Of 48 087 infants included in the analysis, 81.8% survived to 32 weeks postmenstrual age, and 95% of survivors were screened for ROP. Rates of any ROP ranged from 25.2% to 91.0% in Switzerland and Japan, respectively, among those examined. The overall rate of those receiving treatment was 24.9%, which varied from 4.3% to 30.4%. Adjusted risk ratios for ROP treatment were lower for Switzerland in all pairwise comparisons, whereas Japan displayed significantly higher ratios. Comparisons of the composite outcome between countries revealed similar, but less marked differences.CONCLUSIONS: Rates of any ROP and ROP treatment varied significantly between iNeo members, while an overall decline in ROP treatment was observed during the study period. It is unclear whether these variations represent differences in care practices, diagnosis and/or treatment thresholds.
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| 18. |
- Darlow, Brian A, et al.
(författare)
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Variations in Oxygen Saturation Targeting, and Retinopathy of Prematurity Screening and Treatment Criteria in Neonatal Intensive Care Units : An International Survey
- 2018
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Ingår i: Neonatology. - : S. Karger AG. - 1661-7800 .- 1661-7819. ; 114:4, s. 323-331
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Rates of retinopathy of prematurity (ROP) and ROP treatment vary between neonatal intensive care units (NICUs). Neonatal care practices, including oxygen saturation (SpO2) targets and criteria for the screening and treatment of ROP, are potential contributing factors to the variations.OBJECTIVES: To survey variations in SpO2 targets in 2015 (and whether there had been recent changes) and criteria for ROP screening and treatment across the networks of the International Network for Evaluating Outcomes in Neonates (iNeo).METHODS: Online prepiloted questionnaires on treatment practices for preterm infants were sent to the directors of 390 NICUs in 10 collaborating iNeo networks. Nine questions were asked and the results were summarized and compared.RESULTS: Overall, 329/390 (84%) NICUs responded, and a majority (60%) recently made changes in upper and lower SpO2 target limits, with the median set higher than previously by 2-3% in 8 of 10 networks. After the changes, fewer NICUs (15 vs. 28%) set an upper SpO2 target limit > 95% and fewer (3 vs. 5%) a lower limit < 85%. There were variations in ROP screening criteria, and only in the Swedish network did all NICUs follow a single guideline. The initial retinal examination was carried out by an ophthalmologist in all but 6 NICUs, and retinal photography was used in 20% but most commonly as an adjunct to indirect ophthalmoscopy.CONCLUSIONS: There is considerable variation in SpO2 targets and ROP screening and treatment criteria, both within networks and between countries.
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| 19. |
- Gagliardi, L, et al.
(författare)
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Neonatal outcomes of extremely preterm twins by sex pairing: an international cohort study
- 2021
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Ingår i: Archives of disease in childhood. Fetal and neonatal edition. - : BMJ. - 1468-2052 .- 1359-2998. ; 106:1, s. F17-F24
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Tidskriftsartikel (refereegranskat)abstract
- Infant boys have worse outcomes than girls. In twins, the ‘male disadvantage’ has been reported to extend to female co-twins via a ‘masculinising’ effect. We studied the association between sex pairing and neonatal outcomes in extremely preterm twins.DesignRetrospective cohort studySettingEleven countries participating in the International Network for Evaluating Outcomes of Neonates.PatientsLiveborn twins admitted at 23–29 weeks’ gestation in 2007–2015.Main outcome measuresWe examined in-hospital mortality, grades 3/4 intraventricular haemorrhage or cystic periventricular leukomalacia (IVH/PVL), bronchopulmonary dysplasia (BPD), retinopathy of prematurity requiring treatment and a composite outcome (mortality or any of the outcomes above).ResultsAmong 20 924 twins, 38% were from male-male pairs, 32% were from female-female pairs and 30% were sex discordant. We had no information on chorionicity. Girls with a male co-twin had lower odds of mortality, IVH/PVL and the composite outcome than girl-girl pairs (reference group): adjusted OR (aOR) (95% CI) 0.79 (0.68 to 0.92), 0.83 (0.72 to 0.96) and 0.88 (0.79 to 0.98), respectively. Boys with a female co-twin also had lower odds of mortality: aOR 0.86 (0.74 to 0.99). Boys from male-male pairs had highest odds of BPD and composite outcome: aOR 1.38 (1.24 to 1.52) and 1.27 (1.16 to 1.39), respectively.ConclusionsSex-related disparities in outcomes exist in extremely preterm twins, with girls having lower risks than boys and opposite-sex pairs having lower risks than same-sex pairs. Our results may help clinicians in assessing risk in this large segment of extremely preterm infants.
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| 20. |
- Gemmell, L., et al.
(författare)
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Hypertensive disorders of pregnancy and outcomes of preterm infants of 24 to 28 weeks' gestation
- 2016
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Ingår i: Journal of Perinatology. - : Springer Science and Business Media LLC. - 0743-8346 .- 1476-5543. ; 36:12, s. 1067-1072
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the relationship between hypertensive disorders of pregnancy (HDPs) and mortality and major morbidities in preterm neonates born at 24 to 28 weeks of gestation.STUDY DESIGN: Using an international cohort, we retrospectively studied 27 846 preterm neonates born at 24 to 286 weeks of gestation during 2007 to 2010 from 6 national neonatal databases. The incidence of HDP was compared across countries, and multivariable logistic regression analyses were conducted to examine the association of HDP and neonatal outcomes including mortality to discharge, bronchopulmonary dysplasia, severe brain injury, necrotizing enterocolitis and treated retinopathy of prematurity.RESULTS: The incidence of HDP in the entire cohort was 13% (range 11 to 16% across countries). HDP was associated with reduced odds of mortality (adjusted odds ratio (aOR) 0.77; 95% confidence interval (CI) 0.67 to 0.88), severe brain injury (aOR 0.74; 95% CI 0.62 to 0.89) and treated retinopathy (aOR 0.82; 95% CI 0.70 to 0.96), but increased odds of bronchopulmonary dysplasia (aOR 1.16; 95% CI 1.05 to 1.27).CONCLUSIONS: In comparison with neonates born to mothers without HDP, neonates of HDP mothers had lower odds of mortality, severe brain injury and treated retinopathy, but higher odds of bronchopulmonary dysplasia. The impact of maternal HDP on newborn outcomes was inconsistent across outcomes and among countries; therefore, further international collaboration to standardize terminology, case definition and data capture is warranted.
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| 21. |
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| 22. |
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| 23. |
- Helenius, Kjell, et al.
(författare)
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Survival in very preterm infants : an international comparison of 10 national neonatal networks
- 2017
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Ingår i: Pediatrics. - : The American Academy of Pediatrics. - 0031-4005 .- 1098-4275. ; 140:6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To compare survival rates and age at death among very preterm infants in 10 national and regional neonatal networks.METHODS: A cohort study of very preterm infants, born between 24 and 29 weeks' gestation and weighing <1500 g, admitted to participating neonatal units between 2007 and 2013 in the International Network for Evaluating Outcomes of Neonates. Survival was compared by using standardized ratios (SRs) comparing survival in each network to the survival estimate of the whole population.RESULTS: Network populations differed with respect to rates of cesarean birth, exposure to antenatal steroids and birth in nontertiary hospitals. Network SRs for survival were highest in Japan (SR: 1.10; 99% confidence interval: 1.08-1.13) and lowest in Spain (SR: 0.88; 99% confidence interval: 0.85-0.90). The overall survival differed from 78% to 93% among networks, the difference being highest at 24 weeks' gestation (range 35%-84%). Survival rates increased and differences between networks diminished with increasing gestational age (GA) (range 92%-98% at 29 weeks' gestation); yet, relative differences in survival followed a similar pattern at all GAs. The median age at death varied from 4 days to 13 days across networks.CONCLUSIONS: The network ranking of survival rates for very preterm infants remained largely unchanged as GA increased; however, survival rates showed marked variations at lower GAs. The median age at death also varied among networks. These findings warrant further assessment of the representativeness of the study populations, organization of perinatal services, national guidelines, philosophy of care at extreme GAs, and resources used for decision-making.
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| 24. |
- Hines, Delaney, et al.
(författare)
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Scoping review shows wide variation in the definitions of bronchopulmonary dysplasia in preterm infants and calls for a consensus
- 2017
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 106:3, s. 366-374
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Tidskriftsartikel (refereegranskat)abstract
- The use of different definitions for bronchopulmonary dysplasia (BPD) has been an ongoing challenge. We searched papers published in English from 2010 and 2015 reporting BPD as an outcome, together with studies that compared BPD definitions between 1978 and 2015. We found that the incidence of BPD ranged from 6% to 57%, depending on the definition chosen, and that studies that investigated correlations with long-term pulmonary and/or neurosensory outcomes reported moderate-to-low predictive values regardless of the BPD criteria.CONCLUSION: A comprehensive and evidence-based definition for BPD needs to be developed for benchmarking and prognostic use.
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| 25. |
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