| 1. |
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| 3. |
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| 4. |
- Augulyte, Lijana, et al.
(författare)
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Chemical and Ecotoxicological Assessment of Selected Biologically Activated Sorbents for Treating Wastewater Polluted with Petroleum Products with Special Emphasis on Polycyclic Aromatic Hydrocarbons
- 2008
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Ingår i: Water, Air and Soil Pollution. - : Springer. - 0049-6979 .- 1573-2932. ; 195:1-4, s. 243-256
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Tidskriftsartikel (refereegranskat)abstract
- A chemical and ecotoxicological assessment of treatment of wastewater that had been polluted with petroleum products using only Activated Sludge (AS) and four biologically activated sorbents (BASs), consisting of activated sludge plus: coal-based activated carbon (-C1), coconut shell-based activated carbon (-C2), zeolite (-Z), and anthracite (-A) were conducted. The efficiency and robustness of the four wastewater treatment systems were evaluated by calculating the reduced total petroleum hydrocarbon (TPH) and polycyclic aromatic hydrocarbon (PAH) contents and the acute ecotoxicity of the effluents. The chemical analysis showed that the combined treatment systems were very effective for reducing the total petroleum hydrocarbon and readily bioavailable PAH contents. The most efficient systems were the BAS-C1 and -C2, which removed 60–88% and 99.5–99.6% of TPH and PAH, respectively. The activated sludge-only treatment was the least effective for purifying the wastewater. Chemical oxygen demand was reduced by >90% by all carbon-based BASs (BAS-C1, BAS-C2 and BAS-A). Shifts in the relative composition of the individual PAHs were identified in samples taken before and after treatment. Algal and bacterial bioassays showed that the toxicities of effluents following treatment by all four systems (except AS for algae) were reduced by more than 80% and 90%, respectively. However, crustacean tests indicated that the carbon-based BASs reduced the toxicity [V tox(50)] only by 19–67%. Our results indicated that the combination of sorption and biodegradation processes have great potential in the treatment of petroleum products polluted wastewater and is less sensitive for inhibitors of the biological process than treatments in which activated sludge alone is used. The assessment of chemical and ecotoxicological endpoints provided valuable information, but contrasting results for one of the assays indicates that further analysis on the capacity of the different treatment systems is warranted.
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| 5. |
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| 6. |
- Belch, Jill J. F., et al.
(författare)
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Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial
- 2010
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Ingår i: Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. - : Elsevier BV. - 0741-5214. ; 52:4, s. 825-833, 833.e1-2
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Tidskriftsartikel (refereegranskat)abstract
- The combination of clopidogrel plus ASA did not improve limb or systemic outcomes in the overall population of PAD patients requiring below-knee bypass grafting. Subgroup analysis suggests that clopidogrel plus ASA confers benefit in patients receiving prosthetic grafts without significantly increasing major bleeding risk.
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| 7. |
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| 11. |
- Hull, Russell D., et al.
(författare)
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Benefit-to-harm ratio of thromboprophylaxis for patients undergoing major orthopaedic surgery
- 2014
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Ingår i: Thrombosis and Haemostasis. - 0340-6245 .- 2567-689X. ; 111:2, s. 199-212
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Tidskriftsartikel (refereegranskat)abstract
- Surgeons consider the benefit-to-harm ratio when making decisions regarding the use of anticoagulant venous thromboembolism (VIE) prophylaxis. We evaluated the benefit-to-harm ratio of the use of newer anticoagulants as thromboprophylaxis in patients undergoing major orthopaedic surgery using the likelihood of being helped or harmed (LHH), and assessed the effects of variation in the definition of major bleeding on the results. A systematic literature search was performed to identify phase II and phase III studies that compared regulatory authority-approved newer anticoagulants to the low-molecular-weight heparin enoxaparin in patients undergoing major orthopaedic surgery. Analysis of outcomes data estimated the clinical benefit (number-needed-to-treat [NNT] to prevent one symptomatic VIE) and clinical harm (number-needed-to-harm [NNH] or the NNT to cause one major bleeding event) of therapies. We estimated each trial's benefit, to-harm ratio from NNT and NNH values, and expressed this as LHH = (1/NNT)/(1/NNH) = NNH/NNT, Based on reporting of efficacy and safety outcomes, most studies favoured enoxaparin over fondaparinux, and rivaroxaban over enoxaparin. However, when using the LHH metric, most trials favoured enoxaparin over both fondaparinux and rivaroxaban when they included surgical-site bleeding that did not require reoperation in the definition of major bleeding. The exclusion of bleeding at surgical site which did not require reoperation shifted the benefit-to-harm ratio in favour of the newer agents. Variations in the definitions of major bleeding may change the benefit-to-harm ratio and subsequently affect its interpretation. Clinical trials should attempt to improve the consistency of major bleeding reporting.
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| 12. |
- Hull, Russell D., et al.
(författare)
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State-of-the-art review : Assessing the safety profiles of new anticoagulants for major orthopedic surgery thromboprophylaxis
- 2009
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Ingår i: Clinical and applied thrombosis/hemostasis. - : SAGE Publications. - 1076-0296 .- 1938-2723. ; 15:4, s. 377-388
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: The safety and efficacy of new anticoagulants are often initially tested for venous thromboembolism (VTE) prevention in patients undergoing major orthopedic surgery. Concern among surgeons about the risks for bleeding may result in suboptimal use of thrombophylaxis. OBJECTIVE: To evaluate the definitions used to define bleeding outcomes in studies of new anticoagulants and to examine the influence the definition has on the perceived bleeding risk of thromboprophylaxis. METHODS: The MedLine database was searched for phase III studies of new anticoagulants versus the standard comparator, enoxaparin, in patients undergoing major orthopedic surgery. RESULTS: The definitions for major bleeding outcomes varied widely both across and within clinical trial programs of new anticoagulants. Studies which did not include surgical site bleeding in their definition for major bleeding showed lower major bleeding rates in comparison to those that did include this outcome. Other factors that influenced the rate of major bleeding included the timing of prophylaxis initiation in relation to surgery and the dose of anticoagulant therapy. The wide range of definitions used for major bleeding made it difficult to compare bleeding risk among studies of new anticoagulants. CONCLUSIONS: The definitions of bleeding events that clinical trials of thromboprophylaxis use in their assessment of new anticoagulants strongly influences each drug's perceived safety profile and may underestimate bleeding risks. Clinical studies of new anticoagulants urgently need standardization of bleeding definitions to allow intertrial comparability and to ensure consistent reporting of clinically relevant outcomes.
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| 13. |
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| 14. |
- Liapis, C. D., et al.
(författare)
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European continuing medical education in vascular surgery : 5-year results of congresses approved by the Union Européenne des Médecins Spécialistes Section of Vascular Surgery
- 2007
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Ingår i: International Journal of Angiology. - 0392-9590 .- 1827-1839. ; 26:4, s. 361-366
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Continuing medical education (CME) can be defined as ''educational activities that serve to maintain, develop, or increase the knowledge, skills and professional performance of a physician to provide services for patients, the public, or the profession''. CME is a major professional responsibility. The European Board of Vascular Surgery of the Union Européenne des Médecins Spécialistes (UEMS) Section of Vascular Surgery has, through its European Vascular CME (EVCME) Committee, accredited 74 congresses during the 5-year period from 2000-2004. METHODS: Official evaluation forms were completed by the congress participants for a personal appraisal of the quality of the activities. The data in this manuscript focused on questions that were the most relevant and of the greatest interest to the participants. A statistical analysis of the results was performed utilizing ANOVA and Robust tests of equality of means as well as a posthoc analysis for further investigation, and non parametric Wilcoxon signed ranks test. RESULTS: The educational needs of participants regarding new diagnostic and therapeutic modes were stated as ''important'' and ''extremely important'' in the responses at over 80% in total. Over 75% of the participants answered ''extremely important'' and ''important'' to the question ''how important is evidence-based practice to your practice''. CONCLUSION: This survey indicates that the EVCME approved congresses had a positive impact for the vascular surgeon by updating overall knowledge on vascular surgery; the majority of comments by the participants also indicates that EVCME is fulfilling its aim to bring as much evidence-based practice as possible into the daily work schedule of the surgeon by turning knowledge acquired by CME into performance of the participants.
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| 15. |
- Liapis, C. D., et al.
(författare)
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Vascular training and endovascular practice in Europe
- 2009
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 37:1, s. 109-15
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the influence of the status of vascular surgery (VS) training paradigms on the actual practice of endovascular therapy among the European countries. METHODS: An email-based survey concerning vascular surgery training models and endovascular practices of different clinical specialties was distributed to a VS educator within 14 European countries. European Vascular and Endovascular Monitor (EVEM) data also were processed to correlate endovascular practice with training models. RESULTS: Fourteen questionnaires were gathered. Vascular training in Europe appears in 3 models: 1. Mono-specialty (independence): 7 countries, 2. Subspecialty: 5 countries, 3. An existing specialty within general surgery: 2 countries. Independent compared to non-independent certification shortens overall training length (5.9 vs 7.9 years, p=0.006), while increasing overall training devoted specifically to VS (3.9 vs 2.7 years, p=0.008). Among countries with independent certification an average of 76% of aortic and 50% of peripheral endovascular procedures are performed by vascular surgeons, while the corresponding values, for countries with a non-independent certification, are 69% and 36% respectively. Countries with independent vascular certification, despite their lower average endovascular index (procedures per 100,000 population), reported a higher growth rate of aortic endovascular procedures (VS independent 132% vs VS non-independent 87%), within a four-year period (2003-2007). Peripheral endovascular procedures, though, have similar growth rates in both country groups (VS independent 62% vs VS non-independent 60%). CONCLUSIONS: In European countries with VS as an independent specialty, vascular surgeons have a shorter total training period but spend more time in VS training, although they may not undertake a greater proportion of the endovascular procedures their countries appear to have adopted endovascular technologies more rapidly compared to the ones with non-independent VS curricula. Whether such differences influence patient outcomes requires investigation in future studies.
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| 16. |
- Länne, T, et al.
(författare)
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Diameter and compliance in the male human abdominal aorta: influence of age and aortic aneurysm
- 1992
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Ingår i: European Journal of Vascular Surgery. - 0950-821X. ; 6:2, s. 178-184
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Tidskriftsartikel (refereegranskat)abstract
- In this study changes in the diameter and compliance of the distal abdominal aorta (76 healthy Caucasian males, 5-71 years old) were determined non-invasively and related to age by means of an ultrasound phase-locked echo-tracking system. The diameter of the aorta increased not only in the period between 5 and 25 years of age, but also by about 30% between the ages of 25 and 71. The pressure diameter curves at 25, 51 and 70 years were non-linear with flattening between 90 and 110 mmHg, and the slope of the curves declined with age. Thus, the pressure strain elastic modulus (Ep) and stiffness (beta) increased (i.e. compliance decreased) in an exponential manner according to age. A group of 37 males with aneurysmal widening of the distal abdominal aorta had a significant increase in Ep when compared to an age-matched control group. Furthermore, the ranges for both Ep and beta were much larger in the aneurysm group than in the control group, indicating diversity in the pathogenesis of the disease. The non-invasive ultrasonic method of phase-locked echo-tracking is an appropriate method for studying compliance in major arteries under a variety of pathophysiological conditions.
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| 17. |
- Länne, T, et al.
(författare)
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Noninvasive measurement of diameter changes in the distal abdominal aorta in man
- 1992
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Ingår i: Ultrasound in Medicine and Biology. - 0301-5629. ; 18:5, s. 451-457
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Tidskriftsartikel (refereegranskat)abstract
- An ultrasound phase-locked, echo-tracking system was used to determine the dynamic properties of the distal abdominal aorta in 10 Caucasian male subjects (mean age, 25 years). Recordings were made at rest and during the blood pressure increase resulting from isometric exercise. The pressure diameter curve was nonlinear with an inflection at about 90-110 mmHg. Above this pressure range, the vessel was stiffer (less compliant), but the pressure diameter relationship was roughly linear above as well as below the inflection. Individual pressure diameter curves showed hysteresis, i.e., the aorta had a smaller diameter during expansion than during retraction at corresponding pressures. The pressure strain elastic modulus (Ep) and stiffness (beta) were at rest [Mean Arterial Pressure (MAP), 81 mmHg] 0.70 10(5) N/m2 and 6.0, respectively. During isometric exercise (MAP, 122 mmHg), Ep increased significantly by 91% and stiffness (beta) nonsignificantly by 27%. The variability of the compliance determinations was 5% when the ultrasonic system was combined with intra-arterial blood pressure measurements and less than 7% when combined with auscultatory blood pressure measurements. It is concluded that the phase-locked, echo-tracking system fulfills clinical requirements for routine measurements of vascular compliance.
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| 18. |
- Mätzsch, Thomas, et al.
(författare)
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No transplacental passage of standard heparin or an enzymatically depolymerized low molecular weight heparin
- 1991
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Ingår i: Blood Coagulation and Fibrinolysis. - 1473-5733. ; 2:2, s. 273-278
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Tidskriftsartikel (refereegranskat)abstract
- In 21 women who had an abortion by hysterotomy between the 15th and 23rd week of pregnancy, the possibility that unfragmented heparin or low molecular weight heparin (LMWH) passed the placental barrier to the foetus was studied. Laboratory analyses included amidolytic assays of factor Xa inhibitory activity (XaI), antithrombin III (ATIII) and a direct measurement of heparin-like substances in plasma with a competitive binding assay. The ATIII concentration in foetal plasma was about 20% of that in normal human plasma and varied considerably between individuals (2-27%). The XaI activity did not differ between the two treated groups, but the mean XaI activity of the combined groups differed from zero (P less than 0.05). If the XaI activity was corrected for the ATIII concentration, the heparin activities no longer differed significantly from zero. As the concentration of heparin-like substances were above the detection limit (0.35 microgram/ml) in 6/16 analysable samples of foetal plasma, a further 15 women who had not received any heparin were included as controls. In 12/14 analysable foetal plasmas heparin-like substances in concentrations above 0.35 micrograms/ml could be detected. Determination of heparin activity in foetal plasma is thus difficult due to the influence of endogenous ATIII on heparin assays. In conclusion, this study did not demonstrate any evidence for the passage of heparin or LMWH across the placental barrier. No differences were detected whether unfragmented heparin or LMWH had been given to the mothers. Our results also indicate the presence of an endogenous glycosaminoglycan in foetal plasma.
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| 19. |
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| 20. |
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| 21. |
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| 22. |
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| 23. |
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| 24. |
- Tengborn, Lilian, et al.
(författare)
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Recurrent thromboembolism in pregnancy and puerperium. Is there a need for thromboprophylaxis?
- 1989
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Ingår i: American Journal of Obstetrics and Gynecology. - 1097-6868. ; 160:1, s. 90-94
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Tidskriftsartikel (refereegranskat)abstract
- By sending a questionnaire (response rate 93%) to 321 women with a history of venous thromboembolism and previous coagulation tests, 72 patients were identified who had a total of 87 pregnancies after the thromboembolic episode. The main aim of the study was to analyze the influence of prophylaxis during pregnancy and delivery on the development of further thromboembolic complications. During pregnancy there was no difference in frequency of thromboses between the group given prophylaxis (n = 20) and the group not receiving it (n = 67). At delivery the frequency of thrombosis was 5.3% among the 57 women given prophylaxis and 11.1% among the 30 without prophylaxis, a difference that is not significant. The implication of these findings is discussed both concerning the indications for giving prophylaxis and concerning the problem of designing relevant prophylactic trials.
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| 25. |
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| 26. |
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| 27. |
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| 28. |
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| 29. |
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| 30. |
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| 31. |
- Balmer, Marianne E, et al.
(författare)
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Occurrence of Methyl Triclosan, a Transformation Product of the Bactericide Triclosan, in Fish from Various Lakes in Switzerland
- 2004
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Ingår i: Environmental Science & Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 38:2, s. 390-5
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Tidskriftsartikel (refereegranskat)abstract
- The bactericide triclosan and methyl triclosan, an environmental transformation product thereof, have been previously detected in lakes and a river in Switzerland. Both compounds are emitted via wastewater treatment plants (WWTPs), with methyl triclosan probably being formed by biological methylation. Passive sampling with semipermeable membrane devices (SPMDs) showed the presence of methyl triclosan in some lakes, suggesting some potential for bioaccumulation of the compound. In this study, we report the presence of methyl triclosan in fish (white fish, coregonus sp.; roach, rutilus rutilus) from various lakes in Switzerland receiving inputs from WWTPs. Identification of the compound was based on mass spectral (MS) evidence including MS/MS data. The concentrations of methyl triclosan in the fish were up to 35 ng g-1 on a wet weight basis and up to 365 ng g-1 on a lipid basis with concentrations in a relatively narrow range for fish from the same lake (Thunersee, 4-6 ng g-1; Zürichsee, 32-62 ng g-1; Pfäffikersee, 43-56 ng g-1; Greifensee, 165-365 ng g-1, lipid basis). No methyl triclosan (<1 ng g-1, lipid basis) was detected in fish (lake trout, salmo trutta) from a remote lake in Sweden (Häbberstjärnen) and in fish (roach) from a small lake in Switzerland with no input from WWTPs (Hüttnersee, <2-<5 ng g-1, lipid basis). The concentrations of methyl triclosan in fish correlated (r2 = 0.85) with the ratio of population in the watershed to water throughflow of the lakes (P/Q ratio), which is considered to be a measure for the domestic burden from WWTPs to a lake. Passive sampling with SPMDs confirmed the presence of methyl triclosan in lakes and a river (Zürichsee and Greifensee; Limmat) but not in a remote mountain lake (Jörisee) and in Hüttnersee. The bioconcentration factor (BCF) of methyl triclosan estimated from the fish data and SPMD-derived water concentrations was in the order of 1-2.6 × 105 (lipid basis) and thus in the range of other persistent organic pollutants. SPMDs were found to be reliable for monitoring low concentrations of methyl triclosan in surface water. Methyl triclosan appears to be a suitable marker for WWTP-derived lipophilic contaminants in the aquatic environment and fish.
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| 32. |
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| 33. |
- Bengtsson, H, et al.
(författare)
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Expansion pattern and risk of rupture of abdominal aortic aneurysms that were not operated on
- 1993
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Ingår i: European Journal of Surgery. - 1102-4151. ; 159:9, s. 461-467
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To analyse the outcome of selective management of patients with abdominal aortic aneurysms, the expansion patterns of the aneurysms, and the factors that influenced the rate of rupture. DESIGN: Retrospective study. SETTING: Malmo General Hospital, Lund University, Malmo, Sweden. SUBJECTS: 155 patients (96 men and 59 women) with abdominal aortic aneurysms who were not selected for operation for whatever reason were included in the study immediately after their first ultrasound scan. MAIN OUTCOME MEASURES: Mortality, expansion rate (mm/year) measured on ultrasound scan, and rate of rupture of aneurysm. RESULTS: Median aneurysmal diameter was 40 mm (range 20-80), and length (n = 106) 70 (range 28-140). The patients were followed up for a median of 3.4 years (range 0-10.2). A total of 107 patients died and in 21 the aneurysms ruptured (4 were operated on and survived). Thirteen patients were re-evaluated and operated on electively. Ultrasonography was repeated in 98 patients, the median expansion rates (mm/year) were 3.1 (diameter) and 1.9 (length). There was a significant linear relationship between initial size (diameter and length) and rate of expansion of diameter. The risk of rupture was greater in larger aneurysms that were expanding more quickly. The cumulative mortality was not affected by the 21 aneurysms that ruptured. CONCLUSION: Selective management of patients with aortic aneurysms is justified.
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| 34. |
- Bengtsson, H, et al.
(författare)
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Prevalence of abdominal aortic aneurysm in the offspring of patients dying from aneurysm rupture
- 1992
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 79:11, s. 1142-1143
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of abdominal aortic aneurysm (AAA) is high in the brothers of patients with aneurysm. A genetic component in the development of AAA has, therefore, been postulated. In this study the offspring of patients who had died from AAA rupture were invited to undergo ultrasonography of the abdominal aorta. The attendance rate was 69 per cent. Thirty-nine sons of median age 60 (range 45-75) years and 23 daughters of median age 62 (range 42-80) years were examined. Abdominal aortic dilatation was found in eight men and one woman. The presence of aortic dilatation in these nine cases was not related to age, hypertension, smoking or symptoms of occlusive arterial disease. It is concluded that the sons of those who have died from ruptured AAA constitute a high-risk group for the development of this condition and should be considered for further screening.
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| 35. |
- Berger, P., et al.
(författare)
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Validation of the Simulator for Testing and Rating Endovascular SkillS (STRESS)-machine in a setting of competence testing
- 2010
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Ingår i: Journal of Cardiovascular Surgery. - 0021-9509 .- 1827-191X. ; 51:2, s. 253-256
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Endovascular skills are an integral part of modern-day vascular surgery. The STRESS machine has been developed to test these skills in vascular surgeons. This study aims to define an optimal pass/fail cutoff value for the STRESS test score. METHODS: The STRESS machine consists of a dry glass model of the abdominal aorta and its tributaries with various stenotic lesions, elongations, and tortuosities. A camera and computer software are used to simulate plain fluoroscopy-mode. The test subjects are given two assignments after which two reviewers use a combination of the ICEPS and MRS to produce the final total score; 43 subjects were tested. According to previous endovascular experience, subjects were classified into four groups: novice-low (no experience, less than 11 performed procedures, less than 50 assisted procedures), novice-high (11-25 performed procedures, more than 50 assisted procedures), intermediate (1-10 performed and >11-25 assisted procedures, 11-25 performed and >1-10 assisted procedures or 25-50 performed procedures) and advanced (more than 50 performed procedures). RESULTS: Test-score and noted experience showed a correlation of 0.794. All intermediate and advanced test subjects scored more than 50 points compared to 4 out of 15 novices. CONCLUSION: We demonstrated that it is possible to determine an optimal cut-off value for competence testing with the STRESS machine.
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| 36. |
- Bergqvist, AS, et al.
(författare)
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Detection of Fas ligand in the bovine oviduct
- 2005
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Ingår i: Animal Reproduction Science. - : Elsevier Masson. - 0378-4320 .- 1873-2232. ; 86:1-2, s. 71-88
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Tidskriftsartikel (refereegranskat)abstract
- Presence of a Fas-Fas ligand (FasL) system defines the immune-privileged status of certain tissues such as placenta. This study examined the fluids and tissue(s) of the bovine oviduct, where both spermatozoa and early embryos escape elimination by the female immune system, for the presence and the distribution of Fas and FasL, which might provide an explanation for the immune-privilegded site of this organ. In the present study, the immunolocalisation of FasL and Fas, as well as the gene expression of FasL, were determined in the uterotubal junction (UTJ), isthmic (I) and ampullar (A) segments of the oviduct during oestrus and the luteal phase of the oestrous cycle. The degree of apoptosis of oviductal epithelium was examined by the TUNEL method. Oviductal fluid (01317), collected chronically via indwelling catheters from the I or A segments during both non-luteal and luteal phases of the cycle, was analysed for the presence of FasL. The Fas immunostaining was scattered along the epithelium of all regions of the oviduct and cycle stages investigated, whereas FasL immunolabelling was more conspicuous in oestrous samples. This staining disappeared during the luteal phase, which was particularly evident in the sperm reservoir (UTJ and I). There were fewer TUNEL-positive cells than Fas- or FasL-positive cells in the oviductal epithelium, suggesting that tubal Fas and FasL are not directly involved in epithelia apoptosis. Western blot analyses detected FasL in ODF collected from both I and A, most conspicuously as a 24-27 kDa band but also at a 40-45 kDa band level. FasL mRNA was expressed in the epithelial cells from the sperm reservoir and A during both non-luteal and luteal phases. However, the level of expression differed significantly between segments during the luteal phase. The results provide novel evidence that the Fas-FasL system is present in the bovine oviduct and could be involved in mediating survival of spermatozoa and early embryos. (c) 2004 Elsevier B.V. All rights reserved.
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| 37. |
- Bergqvist, D, et al.
(författare)
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Abdominal injury from sporting activities
- 1982
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Ingår i: British journal of sports medicine. - : BMJ. - 1473-0480 .- 0306-3674. ; 16:2, s. 76-79
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Tidskriftsartikel (refereegranskat)abstract
- The frequency of abdominal injury is rising. In an analysis of 1,354 cases of closed abdominal trauma sustained during a 30-year period (1950-1979) in Skaraborg County, Sweden, a distinct increase was found in the numbers associated with sporting activities. The severity of the injuries caused by sports likewise showed an increase. The representation of injured organs was of the same order as in the total series of closed abdominal injuries. An analysis of the 136 cases of sports-associated injury is presented with regard to cause and type of the injuries, diagnosis and prognosis.
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| 38. |
- Bergqvist, D, et al.
(författare)
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Abdominal trauma in persons older than 60 years
- 1982
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 148:7, s. 569-573
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Tidskriftsartikel (refereegranskat)abstract
- Abdominal trauma occurring in persons older than 60 years over a 30-year period (1950-79) in a well defined region of Sweden was reviewed. The 177 patients comprised 12.5% of the total with abdominal trauma during that period. Road traffic accidents were the main cause of trauma (48% of cases). The incidence of motor-car accidents rose sharply during the first two decades of the study. Injuries to the liver and bile ducts and multiple intra-abdominal injuries were more common in the elderly than in younger patients, but injury to the abdominal wall was less common. A tendency towards more severe injuries and multiple trauma with extra-abdominal involvement emerged during the study period. The mortality rate was 27.6% in the patients older than 60, but 9.1% in the overall patient series with abdominal trauma. One-third of all the deaths among the older patients were directly due to the abdominal trauma. One consequence of the increasing numbers of old people in the general population is probably that more and more cases of abdominal trauma will be seen in the higher age groups.
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| 39. |
- Bergqvist, D, et al.
(författare)
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Acute ischaemia of the visceral arteries
- 2007
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Ingår i: Vascular Surgery. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 9783540309550 - 9783540309567 ; , s. 417-423
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 40. |
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| 41. |
- Bergqvist, D, et al.
(författare)
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Arterio-ureteral fistula--a systematic review
- 2001
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Ingår i: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. - 1078-5884. ; 22:3, s. 191-196
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Tidskriftsartikel (refereegranskat)
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| 42. |
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| 43. |
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| 44. |
- Bergqvist, D, et al.
(författare)
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Blunt renal trauma. Analysis of 417 patients
- 1983
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Ingår i: European Urology. - 1873-7560. ; 9:1, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- Case records of 417 patients, from a well-defined area, who were hospitalized because of blunt renal trauma during the period 1950-1979 were analyzed. The incidence increased during the final decade, corresponding to a rising incidence of motor traffic accidents and sports injuries. Young patients, between 10 and 29 years of age, were responsible for the increase and half of all patients were in this age group. Associated injuries were frequent. Emergency urography was rare during the earlier part of the investigation period, but the frequency increased strongly thereafter. Treatment was mainly conservative (nonoperative) except in patients with major renal injuries. Nephrectomy was performed in 22 patients. Reconstructive surgery was performed especially in patients with intermediate renal injuries during the final decade. The total mortality was 6.5%. Only 7 patients (1.7%) died from the renal injury. A dramatic reduction in the hospitalization time was noted.
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| 45. |
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| 46. |
- Bergqvist, D, et al.
(författare)
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Comparison of the cost of preventing postoperative deep vein thrombosis with either unfractionated or low molecular weight heparin
- 1996
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 83:11, s. 1548-1552
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Tidskriftsartikel (refereegranskat)abstract
- The relative costs were analysed of (1) no prophylaxis against deep vein thrombosis (DVT), (2) selective treatment of DVT after confirmation of diagnosis, (3) general prophylaxis with standard low-dose unfractionated heparin and (4) general prophylaxis with low molecular weight heparin (LMWH) in patients undergoing elective general abdominal surgery or elective hip surgery. The mean calculated costs per patient undergoing general abdominal surgery were: Swedish crowns (SEK) 1950 for no prophylaxis, SEK 5710 for selective treatment of DVT, SEK 735 for prophylaxis with unfractionated heparin and SEK 665 for prophylaxis with LMWH. The corresponding costs for hip surgery were SEK 3930, SEK 10790, SEK 1730 and SEK 1390 respectively. Thus, the least expensive management strategy in patients undergoing elective general abdominal or hip surgery would appear to be general prophylaxis with either unfractionated heparin or LMWH. Furthermore, general prophylaxis with LMWH would appear to be more cost-effective than general prophylaxis with unfractionated heparin.
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| 47. |
- Bergqvist, D, et al.
(författare)
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Die Kosteneffektivitat in der Pravention postoperativer Thromboembolien
- 1993
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Ingår i: Orthopade. - 1433-0431. ; 22:2, s. 140-143
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Tidskriftsartikel (refereegranskat)abstract
- Awareness of cost-effectiveness aspects has become increasingly important within the health care sector in times of constrained resources. Health economics deal with methods of making choices under conditions of uncertainty and provide models for decision making. A key question is to compare alternative strategies. Within the field of prophylaxis against venous thromboembolism general thromboprophylaxis is cost-effective provided that the frequency of deep vein thrombosis is higher than 10%. Diagnostic screening and selective treatment of detected thrombosis is always the least cost-effective alternative. Although detailed analyses are still lacking it seems as if the use of low molecular weight heparins is more cost-effective than unfractionated low dose heparin. Besides saving lives by preventing fatal pulmonary embolism an adequate thromboprophylaxis also will provide monetary savings.
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| 48. |
- Bergqvist, D, et al.
(författare)
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Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer.
- 2002
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Ingår i: New England Journal of Medicine. - 0028-4793. ; 346:13, s. 975-980
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Tidskriftsartikel (refereegranskat)abstract
- Background: Abdominal surgery for cancer carries a high risk of venous thromboembolism, but the optimal duration of postoperative thromboprophylaxis is unknown. Methods: We conducted a double-blind, multicenter trial in which patients undergoing planned curative open surgery for abdominal or pelvic cancer received enoxaparin (40 mg subcutaneously) daily for 6 to 10 days and were then randomly assigned to receive either enoxaparin or placebo for another 21 days. Bilateral venography was performed between days 25 and 31, or sooner if symptoms of venous thromboembolism occurred. The primary end point with respect to efficacy was the incidence of venous thromboembolism between days 25 and 31. The primary safety end point was bleeding during the three-week period after randomization. The patients were followed for three months. Results: The intention-to-treat analysis of efficacy included 332 patients. The rates of venous thromboembolism at the end of the double-blind phase were 12.0 percent in the placebo group and 4.8 percent in the enoxaparin group (P=0.02). This difference persisted at three months (13.8 percent vs. 5.5 percent, P=0.01). Three patients in the enoxaparin group and six in the placebo group died within three months after surgery. There were no significant differences in the rates of bleeding or other complications during the double-blind or follow-up periods. Conclusions: Enoxaparin prophylaxis for four weeks after surgery for abdominal or pelvic cancer is safe and significantly reduces the incidence of venographically demonstrated thrombosis, as compared with enoxaparin prophylaxis for one week. (N Engl J Med 2002;346:975-80.) Copyright (C) 2002 Massachusetts Medical Society.
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| 49. |
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| 50. |
- Bergqvist, D, et al.
(författare)
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Extraanatomic vascular reconstruction in patients with aorto-iliac arteriosclerosis
- 1984
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 150:3, s. 205-209
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Tidskriftsartikel (refereegranskat)abstract
- During an 11-year period 117 extraanatomic reconstructions were made for aorto-iliac arteriosclerosis; 36 axillofemoral and 81 femorofemoral crossover bypasses. The patients were old and had several factors making them poor risks for surgery. Axillofemoral grafts were more often used in patients with malignant disease. Postoperative mortality was 10% without difference between the two types of reconstruction. Both early and late complications were significantly more frequent in patients with axillofemoral bypass. Reoperations for occlusion and symptoms from the donor side also were significantly more common among axillofemoral patients. Life table analysis showed a higher survival and patency rate among patients with crossover grafts.
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