| 1. |
- Doria, Andrea S., et al.
(författare)
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Quantitative versus semiquantitative MR imaging of cartilage in blood-induced arthritic ankles: preliminary findings
- 2014
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Ingår i: Pediatric Radiology. - : Springer Science and Business Media LLC. - 1432-1998 .- 0301-0449. ; 44:5, s. 576-586
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Tidskriftsartikel (refereegranskat)abstract
- Recent advances in hemophilia prophylaxis have raised the need for accurate noninvasive methods for assessment of early cartilage damage in maturing joints to guide initiation of prophylaxis. Such methods can either be semiquantitative or quantitative. Whereas semiquantitative scores are less time-consuming to be performed than quantitative methods, they are prone to subjective interpretation. To test the feasibility of a manual segmentation and a quantitative methodology for cross-sectional evaluation of articular cartilage status in growing ankles of children with blood-induced arthritis, as compared with a semiquantitative scoring system and clinical-radiographic constructs. Twelve boys, 11 with hemophilia (A, n = 9; B, n = 2) and 1 with von Willebrand disease (median age: 13; range: 6-17), underwent physical examination and MRI at 1.5 T. Two radiologists semiquantitatively scored the MRIs for cartilage pathology (surface erosions, cartilage loss) with blinding to clinical information. An experienced operator applied a validated quantitative 3-D MRI method to determine the percentage area of denuded bone (dAB) and the cartilage thickness (ThCtAB) in the joints' MRIs. Quantitative and semiquantitative MRI methods and clinical-radiographic constructs (Hemophilia Joint Health Score [HJHS], Pettersson radiograph scores) were compared. Moderate correlations were noted between erosions and dAB (r = 0.62, P = 0.03) in the talus but not in the distal tibia (P > 0.05). Whereas substantial to high correlations (r range: 0.70-0.94, P < 0.05) were observed between erosions, cartilage loss, HJHS and Pettersson scores both at the distal tibia and talus levels, moderate/borderline substantial (r range: 0.55-0.61, P < 0.05) correlations were noted between dAB/ThCtAB and clinical-radiographic constructs. Whereas the semiquantitative method of assessing cartilage status is closely associated with clinical-radiographic scores in cross-sectional studies of blood-induced arthropathy, quantitative measures provide independent information and are therefore less applicable for that research design.
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| 2. |
- Frasier, Lori D., et al.
(författare)
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International issues in abusive head trauma
- 2014
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Ingår i: Pediatric Radiology. - : Springer Science and Business Media LLC. - 0301-0449 .- 1432-1998. ; 44:S4, s. 647-653
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Tidskriftsartikel (refereegranskat)abstract
- In the decades since Dr. John Caffey described a series of children with chronic subdural hematoma and long bone fractures, there has been a substantial increase in the medical recognition of various forms child abuse. In the United States, the term shaken baby syndrome was coined to explain a constellation of injuries assumed to be the result of violent shaking of infants. After improved understanding of the variety of mechanisms that occur when children are abused, abusive head trauma (AHT) has become the recommended terminology. AHT is a more comprehensive term that reflects the brain injuries that children suffer as the result of abuse. AHT continues to include shaking as a mechanism of injury as well as shaking with impact, impact alone, crushing injuries or combinations of several mechanisms. The medical community in the United States has led the way in developing new terminology and research to describe this unique and devastating form of abuse. The globalization of medicine and rapid information transfer has resulted in AHT becoming well-recognized internationally as a form of serious and fatal child abuse. This paper will review the historical basis in the United States for the diagnosis of AHT. We will also review some of the current international issue in epidemiology, diagnosis, legal processes and outcomes in selected countries/regions where child abuse physicians are actively involved in the evaluation of AHT.
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| 3. |
- Precht, Helle, et al.
(författare)
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Digital radiography: optimization of image quality and dose using multi-frequency software
- 2012
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Ingår i: Pediatric Radiology. - : Springer Science and Business Media LLC. - 1432-1998 .- 0301-0449. ; 42:9, s. 1112-1118
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: New developments in processing of digital radiographs (DR), including multi-frequency processing (MFP), allow optimization of image quality and radiation dose. This is particularly promising in children as they are believed to be more sensitive to ionizing radiation than adults. OBJECTIVE: To examine whether the use of MFP software reduces the radiation dose without compromising quality at DR of the femur in 5-year-old-equivalent anthropomorphic and technical phantoms. MATERIALS AND METHODS: A total of 110 images of an anthropomorphic phantom were imaged on a DR system (Canon DR with CXDI-50 C detector and MLT[S] software) and analyzed by three pediatric radiologists using Visual Grading Analysis. In addition, 3,500 images taken of a technical contrast-detail phantom (CDRAD 2.0) provide an objective image-quality assessment. RESULTS: Optimal image-quality was maintained at a dose reduction of 61% with MLT(S) optimized images. Even for images of diagnostic quality, MLT(S) provided a dose reduction of 88% as compared to the reference image. Software impact on image quality was found significant for dose (mAs), dynamic range dark region and frequency band. CONCLUSION: By optimizing image processing parameters, a significant dose reduction is possible without significant loss of image quality.
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| 4. |
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| 5. |
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| 6. |
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| 7. |
- Vult von Steyern, Kristina, et al.
(författare)
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Visualisation of the rectoanal inhibitory reflex with a modified contrast enema in children with suspected Hirschsprung disease.
- 2013
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Ingår i: Pediatric Radiology. - : Springer Science and Business Media LLC. - 1432-1998 .- 0301-0449. ; 43:8, s. 950-957
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with Hirschsprung disease lack the normal rectoanal inhibitory reflex, which can be studied with anorectal manometry or US. OBJECTIVE: To see whether the rectoanal inhibitory reflex could be visualised with a modified contrast enema, thereby increasing the diagnostic accuracy of the contrast enema and reducing the number of rectal biopsies. MATERIALS AND METHODS: Fifty-nine boys and 42 girls (median age, 12 months) with suspected Hirschsprung disease were examined with a modified contrast enema, supplemented with two injections of cold, water-soluble contrast medium, to induce the reflex. Two paediatric radiologists evaluated the anonymised examinations in consensus. The contrast enema findings were correlated with the results of rectal biopsy or clinical follow-up. RESULTS: Five boys and one girl (median age, 7.5 days) were diagnosed with Hirschsprung disease. The negative predictive value of the rectoanal inhibitory reflex was 100%. A contrast enema with signs of Hirschsprung disease in combination with an absent rectoanal inhibitory reflex had the specificity of 98% and sensitivity of 100% for Hirschsprung disease. CONCLUSION: The modified contrast enema improves the radiological diagnosis of Hirschsprung disease. By demonstrating the rectoanal inhibitory reflex in children without Hirschsprung disease, we can reduce the proportion of unnecessary rectal biopsies.
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| 8. |
- Sundbom, Magnus, et al.
(författare)
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Trends in use of upper abdominal procedures in sweden 1998-2011 : a population-based study
- 2014
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Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 38:1, s. 33-39
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Surgical care is constantly developing as demographic shifts occur and indications change when new techniques are introduced. The purpose of this study was to describe trends of in-hospital upper abdominal procedures in Sweden during 1998-2011.METHODS:Data were collected from the National Patient Register containing annual number of procedures and procedures per 100,000 inhabitants. Comparisons were made between the first 3 years (1998-2000) and last 3 years (2009-2011). High-volume procedures and resectional surgery were studied in particular.RESULTS:During the study period, a total of 435,394 upper abdominal procedures were performed in 318,991 individuals. The number of procedures increased 44.9 % between the early and late period. Bariatric surgery increased almost sixfold, with a substantial increase in laparoscopic gastric bypass to 58.2/100,000/year. The most common operation was cholecystectomy, 144.9/100,000/year. Liver resections tripled and, in total, major resectional surgery, performed on the esophagus, stomach, liver, and pancreas, increased by 36.3 %. Per 100,000 adult inhabitants and year, resections of the esophagus was performed in 2.3 patients, stomach in 5.9, liver in 9.0, and pancreas in 5.7, in late time period. An increase in all types of endoscopic work was observed.CONCLUSIONS:In total, the number of upper abdominal procedures performed per inhabitant increased. Laparoscopic gastric bypass increased substantially and became the second most common procedure after laparoscopic cholecystectomy. An increase in resectional surgery was observed.
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| 9. |
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| 10. |
- Balleyguier, Corinne, et al.
(författare)
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Staging of uterine cervical cancer with MRI : guidelines of the European Society of Urogenital Radiology
- 2011
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 21:5, s. 1102-1110
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To design clear guidelines for the staging and follow-up of patients with uterine cervical cancer, and to provide the radiologist with a framework for use in multidisciplinary conferences. Methods: Guidelines for uterine cervical cancer staging and follow-up were defined by the female imaging subcommittee of the ESUR (European Society of Urogenital Radiology) based on the expert consensus of imaging protocols of 11 leading institutions and a critical review of the literature. Results: The results indicated that high field Magnetic Resonance Imaging (MRI) should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine cervix) of the pelvic content. Axial T1-weighted sequence is useful to detect suspicious pelvic and abdominal lymph nodes, and images from symphysis to the left renal vein are required. The intravenous administration of Gadolinium-chelates is optional but is often required for small lesions (< 2 cm) and for follow-up after treatment. Diffusion-weighted sequences are optional but are recommended to help evaluate lymph nodes and to detect a residual lesion after chemoradiotherapy. Conclusions: Expert consensus and literature review lead to an optimized MRI protocol to stage uterine cervical cancer. MRI is the imaging modality of choice for preoperative staging and follow-up in patients with uterine cervical cancer.
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| 11. |
- Kaloshin, Vadim, et al.
(författare)
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An Example of a Nearly Integrable Hamiltonian System with a Trajectory Dense in a Set of Maximal Hausdorff Dimension
- 2012
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Ingår i: Communications in Mathematical Physics. - : Springer Science and Business Media LLC. - 0010-3616 .- 1432-0916. ; 315:3, s. 643-697
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Tidskriftsartikel (refereegranskat)abstract
- The famous ergodic hypothesis suggests that for a typical Hamiltonian on a typical energy surface nearly all trajectories are dense. KAM theory disproves it. Ehrenfest (The Conceptual Foundations of the Statistical Approach in Mechanics. Ithaca, NY: Cornell University Press, 1959) and Birkhoff (Collected Math Papers. Vol 2, New York: Dover, pp 462-465, 1968) stated the quasi-ergodic hypothesis claiming that a typical Hamiltonian on a typical energy surface has a dense orbit. This question is wide open. Herman (Proceedings of the International Congress of Mathematicians, Vol II (Berlin, 1998). Doc Math 1998, Extra Vol II, Berlin: Int Math Union, pp 797-808, 1998) proposed to look for an example of a Hamiltonian near with a dense orbit on the unit energy surface. In this paper we construct a Hamiltonian which has an orbit dense in a set of maximal Hausdorff dimension equal to 5 on the unit energy surface.
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| 12. |
- Syed, Faisal Saeed, et al.
(författare)
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On the fog variability over south Asia
- 2012
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Ingår i: Climate Dynamics. - : Springer Science and Business Media LLC. - 0930-7575 .- 1432-0894. ; 39:12, s. 2993-3005
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Tidskriftsartikel (refereegranskat)abstract
- An increasing trend in fog frequencies over south Asia during winter in the last few decades has resulted in large economical losses and has caused substantial difficulties in the daily lives of people. In order to better understand the fog phenomenon, we investigated the climatology, inter-annual variability and trends in the fog occurrence from 1976 to 2010 using observational data from 82 stations, well distributed over India and Pakistan. Fog blankets large area from Pakistan to Bangladesh across north India from west to east running almost parallel to south of the Himalayas. An EOF analysis revealed that the fog variability over the whole region is coupled and therefore must be governed by some large scale phenomenon on the inter-annual time scale. Significant positive trends were found in the fog frequency but this increase is not gradual, as with the humidity, but comprises of two distinct regimes shifts, in 1990 and 1998, with respect to both mean and variance. The fog is also detected in ERA-Interim 3 hourly, surface and model level forecast data when using the concept of cross-over temperature combined with boundary layer stability. This fog index is able to reproduce the regime shift around 1998 and shows that the method can be applied to analyze fog over south Asia. The inter-annual variability seems to be associated with the wave train originating from the North Atlantic in the upper troposphere that when causing higher pressure over the region results in an increased boundary layer stability and surface-near relative humidity. The trend and shifts in the fog occurrence seems to be associated with the gradual increasing trend in relative humidity from 1990 onwards.
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| 13. |
- Aghajani, T., et al.
(författare)
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Maximum likelihood estimation of local stellar kinematics
- 2013
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Ingår i: Astronomy & Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 551
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Tidskriftsartikel (refereegranskat)abstract
- Context. Kinematical data such as the mean velocities and velocity dispersions of stellar samples are useful tools to study galactic structure and evolution. However, observational data are often incomplete (e. g., lacking the radial component of the motion) and may have significant observational errors. For example, the majority of faint stars observed with Gaia will not have their radial velocities measured. Aims. Our aim is to formulate and test a new maximum likelihood approach to estimating the kinematical parameters for a local stellar sample when only the transverse velocities are known (from parallaxes and proper motions). Methods. Numerical simulations using synthetically generated data as well as real data (based on the Geneva-Copenhagen survey) are used to investigate the statistical properties (bias, precision) of the method, and to compare its performance with the much simpler "projection method" described by Dehnen & Binney (1998, MNRAS, 298, 387). Results. The maximum likelihood method gives more correct estimates of the dispersion when observational errors are important, and guarantees a positive-definite dispersion matrix, which is not always obtained with the projection method. Possible extensions and improvements of the method are discussed.
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| 14. |
- Zethson, T., et al.
(författare)
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eta Carinae: linelist for the emission spectrum of the Weigelt blobs in the 1700 to 10 400 angstrom wavelength region
- 2012
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Ingår i: Astronomy & Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 540
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Tidskriftsartikel (refereegranskat)abstract
- Aims. We present line identifications in the 1700 to 10 400 angstrom region for the Weigelt blobs B and D, located 0.'' 1 to 0 ''.3 NNW of Eta Carinae. The aim of this work is to characterize the behavior of these luminous, dense gas blobs in response to the broad highstate and the short low-state of. Carinae during its 5.54-year spectroscopic period. Methods. The spectra were recorded in a low state (March 1998) and an early high state (February 1999) with the Hubble Space Telescope/Space Telescope Imaging Spectrograph (HST/STIS) from 1640 to 10 400 angstrom using the 52 '' x 0.1 aperture centered on Eta Carinae at position angle, PA = 332 degrees. Extractions of the reduced spectrum including both Weigelt B and D, 0.'' 28 in length along the slit, were used to identify the narrow, nebular emission lines, measure their wavelengths and estimate their fluxes. Results. A linelist of 2500 lines is presented for the high and low states of the combined Weigelt blobs B and D. The spectra are dominated by emission lines from the iron-group elements, but include lines from lighter elements including parity-permitted and forbidden lines. A number of lines are fluorescent lines pumped by H Ly alpha. Other lines show anomalous excitation.
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| 15. |
- Fraser, Abigail, et al.
(författare)
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Maternal diabetes in pregnancy and offspring cognitive ability : sibling study with 723,775 men from 579,857 families
- 2014
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Ingår i: Diabetologia. - : Springer. - 0012-186X .- 1432-0428. ; 57:1, s. 102-109
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Tidskriftsartikel (refereegranskat)abstract
- AIMS/HYPOTHESIS: The aim of this study was to investigate the association between maternal diabetes in pregnancy and offspring cognitive ability and also to assess whether the association was due to intrauterine mechanisms or shared familial characteristics.METHODS: We linked national registers and conducted a prospective cohort study of singleton Swedish-born men to explore associations between maternal pregnancy diabetes and educational achievement at age 16 years, the age of completing compulsory education in Sweden (n = 391,545 men from 337,174 families, graduating in 1988-1997 and n = 326,033 men from 282,079 families, graduating in 1998-2009), and intelligence quotient (IQ) at the mandatory conscription examination at 18 years of age (n = 664,871 from 543,203 families).RESULTS: Among non-siblings, maternal diabetes in pregnancy was associated with lower offspring cognitive ability even after adjustment for maternal age at birth, parity, education, early-pregnancy BMI, offspring birth year, gestational age and birthweight. For example, in non-siblings, the IQ of men whose mothers had diabetes in their pregnancy was on average 1.36 points lower (95% CI -2.12, -0.60) than men whose mothers did not have diabetes. In comparison, we found no such association within sibships (mean difference 1.70; 95% CI -1.80, 5.21).CONCLUSIONS/INTERPRETATION: The association between maternal diabetes in pregnancy and offspring cognitive outcomes is likely explained by shared familial characteristics and not by an intrauterine mechanism.
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| 16. |
- Patterson, C. C., et al.
(författare)
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Trends in childhood type 1 diabetes incidence in Europe during 1989-2008 : evidence of non-uniformity over time in rates of increase
- 2012
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Ingår i: Diabetologia. - : Springer-Verlag New York. - 0012-186X .- 1432-0428. ; 55:8, s. 2142-2147
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe 20-year incidence trends for childhood type 1 diabetes in 23 EURODIAB centres and compare rates of increase in the first (1989-1998) and second (1999-2008) halves of the period. All registers operate in geographically defined regions and are based on a clinical diagnosis. Completeness of registration is assessed by capture-recapture methodology. Twenty-three centres in 19 countries registered 49,969 new cases of type 1 diabetes in individuals diagnosed before their 15th birthday during the period studied. Ascertainment exceeded 90% in most registers. During the 20-year period, all but one register showed statistically significant changes in incidence, with rates universally increasing. When estimated separately for the first and second halves of the period, the median rates of increase were similar: 3.4% per annum and 3.3% per annum, respectively. However, rates of increase differed significantly between the first half and the second half for nine of the 21 registers with adequate coverage of both periods; five registers showed significantly higher rates of increase in the first half, and four significantly higher rates in the second half. The incidence rate of childhood type 1 diabetes continues to rise across Europe by an average of approximately 3-4% per annum, but the increase is not necessarily uniform, showing periods of less rapid and more rapid increase in incidence in some registers. This pattern of change suggests that important risk exposures differ over time in different European countries. Further time trend analysis and comparison of the patterns in defined regions is warranted.
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| 17. |
- Ljungman, David, et al.
(författare)
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Cost-Utility Estimations of Palliative Care in Patients With Pancreatic Adenocarcinoma: A Retrospective Analysis.
- 2013
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Ingår i: World journal of surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; 37:8, s. 1883-1891
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We earlier reported cost-utility estimates in patients who undergo resection aimed at cure for pancreatic carcinoma. The present study describes similar information on patients with unresectable tumors who experienced palliative care only. METHODS: A population-based cohort of patients with exocrine pancreatic adenocarcinoma during 1998-2005 was evaluated retrospectively (n=444). Total direct health care costs at departments of surgery and oncology, for primary health care, and at hospice were achieved. Self-estimated health-related quality of life (HRQL) was assessed by the SF-36. A single preference-based utility index, SF-6D, was derived from SF-36 items to estimate quality-adjusted life years (QALYs). Results were compared to similar findings in a previously reported group of patients with pancreatic carcinoma resected for cure (n=31). RESULTS: Palliative care patients (n=305) had impaired HRQL particularly related to physical domains. The mean preference-based health utility index at diagnosis was 0.65±0.02 [95% confidence interval (CI) 0.61-0.69] compared to 0.77±0.02 (95% CI 0.75-0.79) in healthy reference individuals. Total direct health care costs were 50% in patients on palliative care compared to costs for surgical R0 resections (23,701 and 50,950, respectively). QALYs for 1year from diagnosis were 0.2 (95% CI 0.17-0.23) in patients on palliative care and 0.48 (95% CI 0.44-0.54) in resection patients. Costs per QALY were 118,418 and 106,146, respectively (95% CI 103,048-139,418 and 94,352-115,795). CONCLUSIONS: Optimized palliative care of patients with exocrine pancreatic carcinoma had costs per achieved utility similar to those for surgical resections aimed at cure.
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| 18. |
- Ohrlander, Tomas, et al.
(författare)
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Morphological State as a Predictor for Reintervention and Mortality After EVAR for AAA.
- 2011
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Ingår i: Cardiovascular and Interventional Radiology. - : Springer Science and Business Media LLC. - 1432-086X .- 0174-1551.
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study was designed to assess aorto-iliac morphological characteristics in relation to reintervention and all-cause long-term mortality in patients undergoing standard EVAR for infrarenal AAA. METHODS: Patients treated with EVAR (Zenith(®) Stentgrafts, Cook) between May 1998 and February 2006 were prospectively enrolled in a computerized database where comorbidities and preoperative aneurysm morphology were entered. Reinterventions and mortality were checked until December 1, 2010. Median follow-up time was 68 months. RESULTS: A total of 304 patients were included, of which 86% were men. Median age was 74 years. The reintervention rate was 23.4% (71/304). A greater diameter of the common iliac artery (p = 0.037; hazard ratio (HR) 1.037 [1.002-1.073]) was an independent factor for an increased number of reinterventions. The 30-day mortality rate was 3.0% (9/304). Aneurysm-related deaths due to AAA occurred in 4.9% (15/304). Five patients died due to a concomitant ruptured thoracic aortic aneurysm. The mortality until end of follow-up was 54.3% (165/304). The proportion of deaths caused by vascular diseases was 61.6%. The severity of angulation of the iliac arteries (p = 0.014; HR 1.018 [95% confidence interval (CI) 1.004-1.033]) and anemia (p = 0.044; HR 2.79 [95% CI 1.029-7.556]) remained as independent factors associated with all-cause long-term mortality. The crude reintervention-free survival rate at 1, 3, and 5 years was 84.5%, 64.8%, and 51.6%, respectively. CONCLUSIONS: The initial aorto-iliac morphological state in patients scheduled for standard EVAR for AAA seems to be strongly related to the need for reinterventions and long-term mortality.
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| 19. |
- Ljungman, David, et al.
(författare)
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Cost-Utility Estimation of Surgical Treatment of Pancreatic Carcinoma Aimed at Cure.
- 2011
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Ingår i: World journal of surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; 35:3, s. 662-70
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Little is reported on costs for radical tumor resections of pancreatic carcinoma in relationship to adjusted quality of life survival postoperatively. Therefore, the aim of the present study was to estimate the cost utility of surgical treatment aimed at cure. METHODS: A population-based cohort of patients with exocrine or ampullary pancreatic adenocarcinoma resected for cure in Gothenburg University Hospitals during 1998-2005 were evaluated retrospectively (n=139). Total inpatient and outpatient healthcare costs were available for 103 patients, and health-related quality of life (HRQL) (based on the SF-36 Health Survey) were assessed preoperatively and postoperataively in 119 patients. Survival and utility index (SF-36-6D) across 5years of postoperative follow-up were used to achieve quality adjusted life years. RESULTS: Mean survival after resection was 977days for patients with exocrine pancreatic carcinoma, with expected differences among subgroups as related to disease stage (p<0.01), in agreement with international reports. The HRQL index was 0.65±0.06 preoperatively, 0.63±0.04 early postoperatively (<1year) and 0.69±0.06 at long-term follow-up (1-5years) compared to 0.77±0.02 in age-matched healthy reference individuals from the Swedish population (p<0.05). Total lifetime costs for treatments including surgery and adjuvant chemotherapy were 39,000 per patient, with a mean of 1.13 (95% Confidence Interval [CI] 0.93-1.40) QALYs across 5years follow-up. The cost per QALY was 35,000 (95% CI 28,026-41,947). CONCLUSIONS: Resection aimed at cure of pancreatic exocrine ductal carcinoma provided costs for one quality adjusted year of survival comparable to other complex surgical treatments within cost limits regarded as reasonable to bear by the Swedish health care system, as well as in several other Western countries.
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| 20. |
- Lind, Marcus, 1976, et al.
(författare)
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The relationship between glycaemic control and heart failure in 83,021 patients with type 2 diabetes
- 2012
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 0012-186X .- 1432-0428. ; 55:11, s. 2946-2953
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine the relationship between glycaemic control and hospitalisation for heart failure in patients with type 2 diabetes. Patients included in the Swedish National Diabetes Register (NDR) during 1998-2003 were followed until hospitalisation for heart failure, death or 31 December 2009. Unadjusted and adjusted incidence rates for heart failure were estimated by Poisson regression and relative risk was estimated by Cox regression. In 83,021 patients with type 2 diabetes, 10,969 (13.2%) were hospitalised with a primary or secondary diagnosis of heart failure during a mean follow-up of 7.2 years. The incidence increased by male sex (p < 0.001), older age (p < 0.001) and longer diabetes duration (p < 0.001). In Cox regression adjusting for risk factors of heart failure the HR per each percentage unit higher HbA(1c) (10 mmol/mol) for heart-failure hospitalisation was 1.12 (95% CI 1.10, 1.14). By category of HbA(1c) the HR for heart failure hospitalisation was: HbA(1c) 6.0 to < 7.0% (42 to < 53 mmol/mol), 0.91 (95% CI 0.84, 0.98); HbA(1c) 7.0 to < 8.0% (53 to < 64 mmol/mol), 0.99 (95% CI 0.91, 1.07); HbA(1c) 8.0 to < 9.0% (64 to < 75 mmol/mol), 1.10 (95% CI 1.01, 1.20); HbA(1c) 9.0 to < 10.0% (75 to < 86 mmol/mol), 1.27 (95% CI 1.15, 1.41); HbA(1c) a parts per thousand yen10.0 % (a parts per thousand yen86 mmol/mol), 1.71 (1.51, 1.93) (reference HbA(1c) < 6% [42 mmol/mol]). The HR for patients with HbA(1c) 7.0 to < 8.0% (53 to < 64 mmol/mol) compared with patients with HbA(1c) 6.0 to < 7.0% (42 to < 53 mmol/mol) was 1.09 (95% CI 1.03, 1.14). Poor glycaemic control (HbA(1c) > 7% [53 mmol/mol]) is associated with an increased risk of hospitalisation for heart failure in patients with type 2 diabetes.
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| 21. |
- Zechmeister, Mathias, et al.
(författare)
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The planet search programme at the ESO CES and HARPS. IV. The search for Jupiter analogues around solar-like stars
- 2013
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 552:A78
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Tidskriftsartikel (refereegranskat)abstract
- Context. In 1992 we began a precision radial velocity survey for planets around solar-like stars with the Coudé Echelle Spectrograph and the Long Camera (CES LC) at the 1.4 m telescope in La Silla (Chile) resulting in the discovery of the planet ι Hor b. We have continued the survey with the upgraded CES Very Long Camera (VLC) and the HARPS spectrographs, both at the 3.6 m telescope, until 2007. Aims: In this paper we present additional radial velocities for 31 stars of the original sample with higher precision. The observations cover a time span of up to 15 years and permit a search for Jupiter analogues. Methods: The survey was carried out with three different instruments/instrument configurations using the iodine absorption cell and the ThAr methods for wavelength calibration. We combine the data sets and perform a joint analysis for variability, trends, and periodicities. We compute Keplerian orbits for companions and detection limits in case of non-detections. Moreover, the HARPS radial velocities are analysed for correlations with activity indicators (CaII H&K and cross-correlation function shape). Results: We achieve a long-term RV precision of 15 m/s (CES+LC, 1992-1998), 9 m/s (CES+VLC, 1999-2006), and 2.8 m/s (HARPS, 2003-2009, including archive data), respectively. This enables us to confirm the known planetary signals in ι Hor and HR 506 as well as the three known planets around HR 3259. A steady RV trend for ɛ Ind A can be explained by a planetary companion and calls for direct imaging campaigns. On the other hand, we find previously reported trends to be smaller for β Hyi and not present for α Men. The candidate planet ɛ Eri b was not detected despite our better precision. Also the planet announced for HR 4523 cannot be confirmed. Long-term trends in several of our stars are compatible with known stellar companions. We provide a spectroscopic orbital solution for the binary HR 2400 and refined solutions for the planets around HR 506 and ι Hor. For some other stars the variations could be attributed to stellar activity, as e.g. the magnetic cycle in the case of HR 8323. Conclusions: The occurrence of two Jupiter-mass planets in our sample is in line with the estimate of 10% for the frequency of giant planets with periods smaller than 10 yr around solar-like stars. We have not detected a Jupiter analogue, while the detections limits for circular orbits indicate at 5 AU a sensitivity for minimum mass of at least 1MJup (2MJup) for 13% (61%) of the stars.
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