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- Agren, A, et al.
(författare)
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In response
- 2014
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Ingår i: Anesthesia and analgesia. - 1526-7598. ; 119:6, s. 1453-1453
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Almskog, LM, et al.
(författare)
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A retrospective register study comparing fibrinogen treated trauma patients with an injury severity score matched control group
- 2020
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Ingår i: Scandinavian journal of trauma, resuscitation and emergency medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 28:1, s. 5-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundFibrinogen concentrate (FC) is frequently used to treat bleeding trauma patients, although the clinical effects are not well known. In this study we describe demographic and clinical outcome data in a cohort of trauma patients receiving FC, compared to a matched control group, who did not receive FC.MethodsThis retrospective, single-center, observational study included adult trauma patients admitted to a level 1-trauma center in Sweden between January 2013 and June 2015. The study population consisted of patients to whom FC was administrated within 24 h (n = 138, “Fib+”). Patients with Injury Severity Score (ISS) > 49 and/or deceased within 1 h from arrival were excluded (n = 30). Controls (n = 108) were matched for age, gender and ISS (“Fib-“). Primary outcome was mortality (24 h−/30 days−/1 year-), and secondary outcomes were blood transfusions, thromboembolic events and organ failure.ResultsThe Fib+ group, despite having similar ISS as Fib-, had higher prevalence of penetrating trauma and lower Glasgow Coma Scale (GCS), indicating more severe injuries. Patients receiving FC had a higher mortality after 24 h/ 30 days/ 1 year compared to controls (Fib-). However, in a propensity score matched model, the differences in mortality between Fib+ and Fib- were no longer significant. Blood transfusions were more common in the Fib+ group, but no difference was observed in thromboembolic events or organ failure. In both groups, low as well as high P-fibrinogen levels at arrival were associated with increased mortality, with the lowest mortality observed at P-fibrinogen values of 2–3 g/l.ConclusionsDespite equal ISS, patients receiving FC had a higher mortality compared to the control group, presumably associated to the fact that these patients were bleeding and physiologically deranged on arrival. When applying a propensity score matching approach, the difference in mortality between the groups was no longer significant. No differences were observed between the groups regarding thromboembolic events or organ failure, despite higher transfusion volumes in patients receiving FC.
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- Almskog, LM, et al.
(författare)
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Rotational thromboelastometry results are associated with care level in COVID-19
- 2021
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Ingår i: Journal of thrombosis and thrombolysis. - : Springer Science and Business Media LLC. - 1573-742X .- 0929-5305. ; 51:2, s. 437-445
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Tidskriftsartikel (refereegranskat)abstract
- High prevalence of thrombotic events in severely ill COVID-19 patients have been reported. Pulmonary embolism as well as microembolization of vital organs may in these individuals be direct causes of death. The identification of patients at high risk of developing thrombosis may lead to targeted, more effective prophylactic treatment. The primary aim of this study was to test whether rotational thromboelastometry (ROTEM) at admission indicates hypercoagulopathy and predicts the disease severity, assessed as care level, in COVID-19 patients. The study was designed as a prospective, observational study where COVID-19 patients over 18 years admitted to hospital were eligible for inclusion. Patients were divided into two groups depending on care level: (1) regular wards or (2) wards with specialized ventilation support. Conventional coagulation tests, blood type and ROTEM were taken at admission. 60 patients were included; age 61 (median), 67% men, many with comorbidities (e.g. hypertension, diabetes). The ROTEM variables Maximum Clot Firmness (EXTEM-/FIBTEM-MCF) were higher in COVID-19 patients compared with in healthy controls (p < 0.001) and higher in severely ill patients compared with in patients at regular wards (p < 0.05). Our results suggest that hypercoagulopathy is present early in patients with mild to moderate disease, and more pronounced in severe COVID-19 pneumonia. Non-O blood types were not overrepresented in COVID-19 positive patients. ROTEM variables showed hypercoagulopathy at admission and this pattern was more pronounced in patients with increased disease severity. If this feature is to be used to predict the risk of thromboembolic complications further studies are warranted.
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- Capitanio, L., et al.
(författare)
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EREBUS: the EuRopean Extinction BUmp Survey
- 2020
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Ingår i: Experimental astronomy. - : Springer. - 0922-6435 .- 1572-9508. ; 50:1, s. 145-158
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Tidskriftsartikel (refereegranskat)abstract
- Dust in the Interstellar Medium (ISM) is intimately linked to the life cycle of stars. Despite being of such fundamental importance to galaxy evolution, the dynamic behaviour and composition of the ISM are not yet fully understood. Observations of reddened Milky Way OB stars have revealed a strong UV extinction feature around 2175 Å and a precipitous extinction rise to the far UV along the lines of sight. Whilst the carrier(s) for this are at present still being debated, multiple laboratory studies suggest carbonate grains to be the key constituent. EREBUS is a mission concept being developed to study the composition of the ISM in both the Milky Way and Local Group Galaxies, primarily by mapping the spatial distribution of the UV extinction features. As these features are sensitive to the dust composition along the line of sight, EREBUS will provide a wealth of information about the spatial distribution and dynamic behaviour of the carrier(s). The mission proposes to deploy a satellite observatory equipped with a coarse UV spectrograph to map the extinction curve variability in the Milky Way in 3 dimensions and in the Local Group in 2 dimensions. In this paper, we discuss the scientific goals for the project, discuss a proposed observation strategy using an iterative process to develop a hierarchical map, and finally outline the instrument requirements and preliminary spacecraft architecture.
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- Edgren, G., et al.
(författare)
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Searching for unknown transfusion-transmitted hepatitis viruses : a binational cohort study of 1.5 million transfused patients
- 2018
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Ingår i: Journal of Internal Medicine. - : WILEY. - 0954-6820 .- 1365-2796. ; 284:1, s. 92-103
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Tidskriftsartikel (refereegranskat)abstract
- Background. Both hepatitis B and C viruses were transmitted through blood transfusion before implementation of donor screening. The existence of additional, yet unknown transfusion transmittable agents causing liver disease could have important public health implications.Methods. Analyses were based on the Scandinavian Donations and Transfusions (SCANDAT2) database. Cox regression models were used to estimate the hazard ratio (HR) of developing chronic liver disease in recipients of blood from donors who later developed any chronic liver disease compared to recipients who received blood transfusion from healthy donors. We also studied whether the risk of liver disease was increased in patients who received units from high-risk' donors, defined as donors who had a higher than expected occurrence of liver disease amongst their previous recipients. All analyses were stratified before and after 1992 to account for the effect of screening for hepatitis C virus.Results. A total of 1 482 922 transfused patients were included in the analyses. Analyses showed evidence of transfusion transmission of liver diseases before, but not after the implementation of hepatitis C virus screening in 1992, with HRs for any liver disease of 1.38 [95% confidence interval (CI), 1.30-1.46] and 0.99 (95% CI, 0.91-1.07), before and after 1992, respectively. Similarly, blood components from 'high-risk' donors conferred increased risks before, but not after 1992.Conclusions. Our data provide no evidence for transfusion transmission of agents causing liver disease after the implementation of screening for hepatitis B and C, and suggest that if such transmission does occur, it is rare.
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- Hjalgrim, H, et al.
(författare)
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Cancer incidence in blood transfusion recipients
- 2007
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Ingår i: Journal of the National Cancer Institute. - : Oxford University Press (OUP). - 1460-2105 .- 0027-8874. ; 99:24, s. 1864-1874
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Tidskriftsartikel (refereegranskat)
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- Messerli-Burgy, N, et al.
(författare)
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Psychological coping and recurrent major adverse cardiac events following acute coronary syndrome
- 2015
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Ingår i: The British journal of psychiatry : the journal of mental science. - : Royal College of Psychiatrists. - 1472-1465. ; 207:3, s. 256-261
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Tidskriftsartikel (refereegranskat)abstract
- Depressed mood and stress are associated with recurrent adverse outcomes following acute coronary syndrome (ACS), but the impact of psychological coping style has not been evaluated in detail.AimsWe tested the relationship between task-oriented coping and event-free survival following ACS.MethodWe followed 158 patients with ACS for an average of 59.8 months for major adverse cardiac outcomes. Psychological coping was assessed with the Coping Inventory of Stressful Situations.ResultsCompared with patients in the lower half of the distribution, those reporting higher task-oriented coping had a reduced hazard of adverse cardiac events (hazard ratio (HR) = 0.28, 95% CI 0.11–0.68, P=0.005) independently of demographic, clinical and behavioural covariates. The combination of low task-oriented coping and high depressive symptoms showed a strong association with adverse outcomes (HR = 6.25, 95% CI 1.88–20.82, P=0.003).ConclusionsThe tendency to cope using task-oriented strategies may promote event-free survival following ACS.
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- Requena-Mendez, A, et al.
(författare)
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High Prevalence of Strongyloidiasis in Spain: A Hospital-Based Study
- 2020
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Ingår i: Pathogens (Basel, Switzerland). - : MDPI AG. - 2076-0817. ; 9:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Strongyloidiasis is a prevailing helminth infection ubiquitous in tropical and subtropical areas, however, seroprevalence data are scarce in migrant populations, particularly for those coming for Asia. Methods: This study aims at evaluating the prevalence of S. stercoralis at the hospital level in migrant populations or long term travellers being attended in out-patient and in-patient units as part of a systematic screening implemented in six Spanish hospitals. A cross-sectional study was conducted and systematic screening for S. stercoralis infection using serological tests was offered to all eligible participants. Results: The overall seroprevalence of S. stercoralis was 9.04% (95%CI 7.76–10.31). The seroprevalence of people with a risk of infection acquired in Africa and Latin America was 9.35% (95%CI 7.01–11.69), 9.22% (7.5–10.93), respectively. The number of individuals coming from Asian countries was significantly smaller and the overall prevalence in these countries was 2.9% (95%CI −0.3–6.2). The seroprevalence in units attending potentially immunosuppressed patients was significantly lower (5.64%) compared with other units of the hospital (10.20%) or Tropical diseases units (13.33%) (p < 0.001). Conclusions: We report a hospital-based strongyloidiasis seroprevalence of almost 10% in a mobile population coming from endemic areas suggesting the need of implementing strongyloidiasis screening in hospitalized patients coming from endemic areas, particularly if they are at risk of immunosuppression.
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