| 1. |
- Jung, Christian, et al.
(författare)
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A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention
- 2019
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Ingår i: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 52, s. 141-148
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed.Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality.Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p < 0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p < 0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02).Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery.
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| 2. |
- Beets-Tan, Regina G. H., et al.
(författare)
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Magnetic resonance imaging for the clinical management of rectal cancer patients : recommendations from the 2012 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting
- 2013
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 23:9, s. 2522-2531
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Tidskriftsartikel (refereegranskat)abstract
- To develop guidelines describing a standardised approach regarding the acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for clinical staging and restaging of rectal cancer. A consensus meeting of 14 abdominal imaging experts from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) was conducted following the RAND-UCLA Appropriateness Method. Two independent (non-voting) chairs facilitated the meeting. Two hundred and thirty-six items were scored by participants for appropriateness and classified subsequently as appropriate or inappropriate (defined by a parts per thousand yen 80 % consensus) or uncertain (defined by < 80 % consensus). Items not reaching 80 % consensus were noted. Consensus was reached for 88 % of items: recommendations regarding hardware, patient preparation, imaging sequences, angulation, criteria for MRI assessment and MRI reporting were constructed from these. These expert consensus recommendations can be used as clinical guidelines for primary staging and restaging of rectal cancer using MRI. These guidelines recommend standardised imaging for staging and restaging of rectal cancer. The guidelines were constructed through consensus amongst 14 abdominal imaging experts. Consensus was reached by in 88 % of 236 items discussed.
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| 3. |
- Dalton, April S., et al.
(författare)
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Deglaciation of the north American ice sheet complex in calendar years based on a comprehensive database of chronological data: NADI-1
- 2023
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Ingår i: QUATERNARY SCIENCE REVIEWS. - 0277-3791 .- 1873-457X. ; 321
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Tidskriftsartikel (refereegranskat)abstract
- The most recent deglaciation of the North American Ice Sheet Complex (NAISC: comprising the Innuitian, Cordilleran, and Laurentide ice sheets) offers a broad perspective from which to analyze the timing and rate of ice retreat, deglacial sea-level rise, and abrupt climate change events. Previous efforts to portray the retreat of the NAISC have been focused largely on minimum-limiting radiocarbon ages and ice margin location(s) tied to deglacial landforms that were not, for the most part, chronologically constrained. Here, we present the first version of North American Deglaciation Isochrones (NADI-1) spanning 25 to 1 ka in calendar years before present. Key new features of this work are (i) the incorporation of cosmogenic nuclide data, which offer a direct constraint on the timing of ice recession; (ii) presentation of all data and time-steps in calendar years; (iii) optimal, minimum, and maximum ice extents for each time-step that are designed to capture uncertainties in the ice margin position, and; (iv) extensive documentation and justification for the placement of each ice margin. Our data compilation includes 2229 measurements of Be-10, 459 measurements of Al-26 and 35 measurements of Cl-36 from a variety of settings, including boulders, bedrock surfaces, cobbles, pebbles, and sediments. We also updated a previous radiocarbon dataset (n = 4947), assembled luminescence ages (n = 397) and gathered uranium-series data (n = 2). After scrutiny of the geochronological dataset, we consider >90% of data to be reliable or likely reliable. Key findings include (i) a highly asynchronous maximum glacial extent in North America, occurring as early as 27 ka to as late as 17 ka, within and between ice sheets. In most marine realms, extension of the ice margin to the continental shelf break at 25 ka is somewhat speculative because it is based on undated and spatially scattered ice stream and geomorphic evidence; (ii) detachment of the Laurentide and Cordilleran ice sheets took place gradually via southerly and northerly 'unzipping' of the ice masses, starting at 17.5 ka and ending around 14 ka; (iii) the final deglaciation of Hudson Bay began at 8.5 ka, with the collapse completed by 8 ka. The maximum extent of ice during the last glaciation occurred at 22 ka and covered 15,470,000 km(2). All North American ice sheets merged at 22 ka for the first time in the Quaternary. The highly asynchronous Last Glacial Maximum in North America means that our isochrones (starting at 25 ka) capture ice advance across some areas, which is based on limited evidence and is therefore somewhat speculative. In the Supplementary Data, the complete NADI-1 chronology is available in PDF, GIF and shapefile format, together with additional visualizations and spreadsheets of geochronological data. The NADI-1 shapefiles are also available at https://doi.org/10.5281/zenodo.8161764.
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| 5. |
- Sardanelli, Francesco, et al.
(författare)
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The Role of Imaging Specialists as Authors of Systematic Reviews on Diagnostic and Interventional Imaging and Its Impact on Scientific Quality : Report from the EuroAIM Evidence-based Radiology Working Group
- 2014
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Ingår i: Radiology. - : Radiological Society of North America (RSNA). - 0033-8419 .- 1527-1315. ; 272:2, s. 533-540
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Forskningsöversikt (refereegranskat)abstract
- Purpose: To evaluate the inclusion of radiologists or nuclear medicine physicians (imaging specialists) as authors of systematic reviews (SRs) on imaging and imaging-guided diagnostic procedures and to determine the impact of imaging specialists' presence as authors on the overall quality of the reviews.Materials and Methods: A MEDLINE and EMBASE search was performed for SRs of diagnostic and interventional image-guided procedures that were published from January 2001 to December 2010. SRs about procedures primarily performed by nonimaging specialists were excluded. The inclusion of imaging specialists among the SR authors and the frequency of publication in imaging journals were evaluated. The quality of a subset of 200 SRs (100 most recent SRs with imaging specialists as authors and 100 most recent SRs without imaging specialists as authors) was rated by using a 12-item modified assessment of multiple SRs (AMSTAR) evaluation tool. Spearman, chi(2), and Mann-Whitney statistics were used.Results: From among 3258 retrieved citations, 867 SRs were included in the study. Neuroimaging had the largest number of SRs (28% [241 of 867]), 41% (354 of 867) of SRs concerned diagnostic performance, and 26% (228 of 867) of SRs were published in imaging journals. Imaging specialists were authors (in any position) in 330 (38%) of 867 SRs; they were first authors of 176 SRs and last authors of 161 SRs. SRs with imaging specialists as authors were more often published in imaging journals than in nonimaging journals (54% [179 of 330] vs 9% [49 of 537]; P < .001). The median number of modified AMSTAR quality indicators was nine in SRs with imaging specialists as authors, while that in SRs without imaging specialists as authors was seven (P = .003).Conclusion: Only 38% (330 of 867) of SRs on radiology or nuclear medicine-related imaging published from January 2001 to December 2010 included imaging specialists as authors. However, the inclusion of imaging specialists as authors was associated with a significant increase in the scientific quality (as judged by using a modified AMSTAR scale) of the SR.
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| 8. |
- Foulger, Gillian R., et al.
(författare)
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The Iceland Microcontinent and a continental Greenland-Iceland-Faroe Ridge
- 2020
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Ingår i: Earth-Science Reviews. - : Elsevier BV. - 0012-8252 .- 1872-6828. ; 206
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Forskningsöversikt (refereegranskat)abstract
- The breakup of Laurasia to form the Northeast Atlantic Realm disintegrated an inhomogeneous collage of cratons sutured by cross-cutting orogens. Volcanic rifted margins formed that are underlain by magma-inflated, extended continental crust. North of the Greenland-Iceland-Faroe Ridge a new rift–the Aegir Ridge–propagated south along the Caledonian suture. South of the Greenland-Iceland-Faroe Ridge the proto-Reykjanes Ridge propagated north through the North Atlantic Craton along an axis displaced ~150 km to the west of the rift to the north. Both propagators stalled where the confluence of the Nagssugtoqidian and Caledonian orogens formed an ~300-km-wide transverse barrier. Thereafter, the ~150 × 300-km block of continental crust between the rift tips–the Iceland Microcontinent–extended in a distributed, unstable manner along multiple axes of extension. These axes repeatedly migrated or jumped laterally with shearing occurring between them in diffuse transfer zones. This style of deformation continues to the present day in Iceland. It is the surface expression of underlying magma-assisted stretching of ductile continental crust that has flowed from the Iceland Microplate and flanking continental areas to form the lower crust of the Greenland-Iceland-Faroe Ridge. Icelandic-type crust which underlies the Greenland-Iceland-Faroe Ridge is thus not anomalously thick oceanic crust as is often assumed. Upper Icelandic-type crust comprises magma flows and dykes. Lower Icelandic-type crust comprises magma-inflated continental mid- and lower crust. Contemporary magma production in Iceland, equivalent to oceanic layers 2–3, corresponds to Icelandic-type upper crust plus intrusions in the lower crust, and has a total thickness of only 10–15 km. This is much less than the total maximum thickness of 42 km for Icelandic-type crust measured seismically in Iceland. The feasibility of the structure we propose is confirmed by numerical modeling that shows extension of the continental crust can continue for many tens of millions of years by lower-crustal ductile flow. A composition of Icelandic-type lower crust that is largely continental can account for multiple seismic observations along with gravity, bathymetric, topographic, petrological and geochemical data that are inconsistent with a gabbroic composition for Icelandic-type lower crust. It also offers a solution to difficulties in numerical models for melt-production by downward-revising the amount of melt needed. Unstable tectonics on the Greenland-Iceland-Faroe Ridge can account for long-term tectonic disequilibrium on the adjacent rifted margins, the southerly migrating rift propagators that build diachronous chevron ridges of thick crust about the Reykjanes Ridge, and the tectonic decoupling of the oceans to the north and south. A model of complex, discontinuous continental breakup influenced by crustal inhomogeneity that distributes continental material in growing oceans fits other regions including the Davis Strait, the South Atlantic and the West Indian Ocean.
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| 9. |
- Schiffer, Christian, et al.
(författare)
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Structural inheritance in the North Atlantic
- 2020
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Ingår i: Earth-Science Reviews. - : Elsevier BV. - 0012-8252 .- 1872-6828. ; 206
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Forskningsöversikt (refereegranskat)abstract
- The North Atlantic, extending from the Charlie Gibbs Fracture Zone to the north Norway-Greenland-Svalbard margins, is regarded as both a classic case of structural inheritance and an exemplar for the Wilson-cycle concept. This paper examines different aspects of structural inheritance in the Circum-North Atlantic region: 1) as a function of rejuvenation from lithospheric to crustal scales, and 2) in terms of sequential rifting and opening of the ocean and its margins, including a series of failed rift systems. We summarise and evaluate the role of fundamental lithospheric structures such as mantle fabric and composition, lower crustal inhomogeneities, orogenic belts, and major strike-slip faults during breakup. We relate these to the development and shaping of the NE Atlantic rifted margins, localisation of magmatism, and microcontinent release. We show that, although inheritance is common on multiple scales, the Wilson Cycle is at best an imperfect model for the Circum-North Atlantic region. Observations from the NE Atlantic suggest depth dependency in inheritance (surface, crust, mantle) with selective rejuvenation depending on time-scales, stress field orientations and thermal regime. Specifically, post-Caledonian reactivation to form the North Atlantic rift systems essentially followed pre-existing orogenic crustal structures, while eventual breakup reflected a change in stress field and exploitation of a deeper-seated, lithospheric-scale shear fabrics. We infer that, although collapse of an orogenic belt and eventual transition to a new ocean does occur, it is by no means inevitable.
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| 10. |
- Spada, Cristiano, et al.
(författare)
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Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline.
- 2014
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Ingår i: Endoscopy. - : Georg Thieme Verlag KG. - 1438-8812 .- 0013-726X. ; 46:10, s. 897-915
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Tidskriftsartikel (refereegranskat)abstract
- This is an official guideline of the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR). It addresses the clinical indications for the use of computed tomographic colonography (CTC). A targeted literature search was performed to evaluate the evidence supporting the use of CTC. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations 1 ESGE/ESGAR recommend computed tomographic colonography (CTC) as the radiological examination of choice for the diagnosis of colorectal neoplasia. ESGE/ESGAR do not recommend barium enema in this setting (strong recommendation, high quality evidence). 2 ESGE/ESGAR recommend CTC, preferably the same or next day, if colonoscopy is incomplete. Delay of CTC should be considered following endoscopic resection. In the case of obstructing colorectal cancer, preoperative contrast-enhanced CTC may also allow location or staging of malignant lesions (strong recommendation, moderate quality evidence). 3 When endoscopy is contraindicated or not possible, ESGE/ESGAR recommend CTC as an acceptable and equally sensitive alternative for patients with symptoms suggestive of colorectal cancer (strong recommendation, high quality evidence). 4 ESGE/ESGAR recommend referral for endoscopic polypectomy in patients with at least one polyp ≥ 6 mm in diameter detected at CTC. CTC surveillance may be clinically considered if patients do not undergo polypectomy (strong recommendation, moderate quality evidence). 5 ESGE/ESGAR do not recommend CTC as a primary test for population screening or in individuals with a positive first-degree family history of colorectal cancer (CRC). However, it may be proposed as a CRC screening test on an individual basis providing the screenee is adequately informed about test characteristics, benefits, and risks (weak recommendation, moderate quality evidence).
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