| 1. |
|
|
| 2. |
|
|
| 3. |
- Aspelin, P, et al.
(författare)
-
Nephrotoxic effects in high-risk patients undergoing angiography
- 2003
-
Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 348:6, s. 491-499
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The use of iodinated contrast medium can result in nephropathy. Whether iso-osmolar contrast medium is less nephrotoxic than low-osmolar contrast medium in high-risk patients is uncertain. METHODS: We conducted a randomized, double-blind, prospective, multicenter study comparing the nephrotoxic effects of an iso-osmolar, dimeric, nonionic contrast medium, iodixanol, with those of a low-osmolar, nonionic, monomeric contrast medium, iohexol. The study involved 129 patients with diabetes with serum creatinine concentrations of 1.5 to 3.5 mg per deciliter who underwent coronary or aortofemoral angiography. The primary end point was the peak increase from base line in the creatinine concentration during the three days after angiography. Other end points were an increase in the creatinine concentration of 0.5 mg per deciliter or more, an increase of 1.0 mg per deciliter or more, and a change in the creatinine concentration from day 0 to day 7. RESULTS: The creatinine concentration increased significantly less in patients who received iodixanol. From day 0 to day 3, the mean peak increase in creatinine was 0.13 mg per deciliter in the iodixanol group and 0.55 mg per deciliter in the iohexol group (P=0.001, the increase with iodixanol minus the increase with iohexol, -0.42 mg per deciliter [95 percent confidence interval, -0.73 to -0.22]). Two of the 64 patients in the iodixanol group (3 percent) had an increase in the creatinine concentration of 0.5 mg per deciliter or more, as compared with 17 of the 65 patients in the iohexol group (26 percent) (P=0.002, odds ratio for such an increase in the iodixanol group, 0.09 [95 percent confidence interval, 0.02 to 0.41]). No patient receiving iodixanol had an increase of 1.0 mg per deciliter or more, but 10 patients in the iohexol group (15 percent) did. The mean change in the creatinine concentration from day 0 to day 7 was 0.07 mg per deciliter in the iodixanol group and 0.24 mg per deciliter in the iohexol group (P=0.003, value in the iodixanol group minus the value in the iohexol group, -0.17 mg per deciliter [95 percent confidence interval, -0.34 to -0.07]). CONCLUSIONS: Nephropathy induced by contrast medium may be less likely to develop in high-risk patients when iodixanol is used rather than a low-osmolar, nonionic contrast medium.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Belfrage, Henrik, et al.
(författare)
-
Management of violent behaviour in the correctional system using qualified risk assessments.
- 2004
-
Ingår i: Legal and Criminological Psychology. - : Wiley-Blackwell. - 1355-3259 .- 2044-8333. ; 9:1, s. 11-22
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose. This study focused on whether institutional violence in a maximum-security correctional institution could be prevented using comprehensive risk assessments followed by adequate risk management. And, could this be shown by a decrease in risk factors for violence according to the HCR-20 Risk Assessment Scheme in the study group? Methods. Offenders with a history of violent criminality were subject to real-life assessments using the HCR-20 Risk Assessment Scheme. The assessments were followed by discussions with members of staff, in which risk management strategies were designed. Thus, the members of staff were fully aware of every inmate's personality characteristics (e.g. psychiatric diagnoses), what risk factors for violence they displayed, and how best to manage those risk factors. With the aim of evaluating the possible effects of our interventions, approximately one third of the study group was reassessed after a mean of 12 months. Results. The follow-up showed no significant decrease in important risk factors for violence in the study group. However, the number of violent incidents showed a remarkable decrease during the study period. Conclusions. Not being able to reduce important risk factors for violence does not necessarily mean that one cannot decrease the risk for, or the incidence of, violence. This study indicates that proper and adequate risk management, using the best protective factors available, can reduce violence even though important risk factors cannot be decreased. The study also supports the theoretical assumption that changes in risk factors are more possible in some populations (e.g. general psychiatric) than in others (e.g. correctional) depending on the nature of the study group and the risk factors that are at hand (e.g. dynamic vs. static). This seems to be important to bear in mind when performing evaluation research using risk assessment instruments.
|
|
| 9. |
|
|
| 10. |
- Belfrage, Henrik, et al.
(författare)
-
Prediction of violence using the HCR-20 : a prospective study in two maximum-security correctional institutions
- 2000
-
Ingår i: Journal of forensic psychiatry (Print). - : Routledge. - 0958-5184 .- 1469-9478. ; 11:1, s. 167-175
-
Tidskriftsartikel (refereegranskat)abstract
- The HCR-20 and the PCL:SV were used in a prospective study of 41 long-term sentenced offenders in two correctional, maximum-security institutions. The aim was to test the validity of these instruments in the prediction of institutional violence. All assessments were made by a comprehensive examination of the offenders' files, completed with clinical interviews ranging from 1 to 3 hours. The mean follow-up time was 8 months. Our results show high predictive validity for the HCR-20's clinical and risk management items, but for almost none of its historical items. The results suggest that violence inside correctional institutions can be predicted with a certain degree of validity by using the HCR-20 and the PCL:SV, even within a selective 'high-risk' group of offenders such as that under study here.
|
|
