| 51. |
- Kolte, Dhaval, et al.
(författare)
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Culprit Vessel-Only Versus Multivessel Percutaneous Coronary Intervention in Patients With Cardiogenic Shock Complicating ST-Segment-Elevation Myocardial Infarction : A Collaborative Meta-Analysis
- 2017
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Ingår i: Circulation. Cardiovascular Interventions. - : LIPPINCOTT WILLIAMS & WILKINS. - 1941-7640 .- 1941-7632. ; 10:11
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Tidskriftsartikel (refereegranskat)abstract
- Background The optimal revascularization strategy in patients with multivessel disease presenting with cardiogenic shock complicating ST-segment-elevation myocardial infarction remains unknown. Methods and Results Databases were searched from 1999 to October 2016. Studies comparing immediate/single-stage multivessel percutaneous coronary intervention (MV-PCI) versus culprit vessel-only PCI (CO-PCI) in patients with multivessel disease, ST-segment-elevation myocardial infarction, and cardiogenic shock were included. Primary end point was short-term (in-hospital or 30 days) mortality. Secondary end points included long-term mortality, cardiovascular death, reinfarction, and repeat revascularization. Safety end points were in-hospital stroke, renal failure, and major bleeding. The meta-analysis included 11 nonrandomized studies and 5850 patients (1157 MV-PCI and 4693 CO-PCI). There was no significant difference in short-term mortality with MV-PCI versus CO-PCI (odds ratio [OR], 1.08; 95% confidence interval [CI], 0.81-1.43; P=0.61). Similarly, there were no significant differences in long-term mortality (OR, 0.84; 95% CI, 0.54-1.30; P=0.43), cardiovascular death (OR, 0.72; 95% CI, 0.42-1.23; P=0.23), reinfarction (OR, 1.65; 95% CI, 0.84-3.26; P=0.15), or repeat revascularization (OR, 1.13; 95% CI, 0.76-1.69; P=0.54) between the 2 groups. There was a nonsignificant trend toward higher in-hospital stroke (OR, 1.64; 95% CI, 0.98-2.72; P=0.06) and renal failure (OR, 1.30; 95% CI, 0.98-1.72; P=0.06), with no difference in major bleeding (OR, 1.47; 95% CI, 0.39-5.63; P=0.57) with MV-PCI when compared with CO-PCI. Conclusions This meta-analysis of nonrandomized studies suggests that in patients with cardiogenic shock complicating ST-segment-elevation myocardial infarction, there may be no significant benefit with single-stage MV-PCI compared with CO-PCI. Given the limitations of observational data, randomized trials are needed to determine the role of MV-PCI in this setting.
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| 53. |
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| 55. |
- Lopes, Renato D., et al.
(författare)
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Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation
- 2019
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Ingår i: New England Journal of Medicine. - : MASSACHUSETTS MEDICAL SOC. - 0028-4793 .- 1533-4406. ; 380:16, s. 1509-1524
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Tidskriftsartikel (refereegranskat)abstract
- Background Appropriate antithrombotic regimens for patients with atrial fibrillation who have an acute coronary syndrome or have undergone percutaneous coronary intervention (PCI) are unclear. Methods In an international trial with a two-by-two factorial design, we randomly assigned patients with atrial fibrillation who had an acute coronary syndrome or had undergone PCI and were planning to take a P2Y(12) inhibitor to receive apixaban or a vitamin K antagonist and to receive aspirin or matching placebo for 6 months. The primary outcome was major or clinically relevant nonmajor bleeding. Secondary outcomes included death or hospitalization and a composite of ischemic events. Results Enrollment included 4614 patients from 33 countries. There were no significant interactions between the two randomization factors on the primary or secondary outcomes. Major or clinically relevant nonmajor bleeding was noted in 10.5% of the patients receiving apixaban, as compared with 14.7% of those receiving a vitamin K antagonist (hazard ratio, 0.69; 95% confidence interval [CI], 0.58 to 0.81; P<0.001 for both noninferiority and superiority), and in 16.1% of the patients receiving aspirin, as compared with 9.0% of those receiving placebo (hazard ratio, 1.89; 95% CI, 1.59 to 2.24; P<0.001). Patients in the apixaban group had a lower incidence of death or hospitalization than those in the vitamin K antagonist group (23.5% vs. 27.4%; hazard ratio, 0.83; 95% CI, 0.74 to 0.93; P=0.002) and a similar incidence of ischemic events. Patients in the aspirin group had an incidence of death or hospitalization and of ischemic events that was similar to that in the placebo group. Conclusions In patients with atrial fibrillation and a recent acute coronary syndrome or PCI treated with a P2Y(12) inhibitor, an antithrombotic regimen that included apixaban, without aspirin, resulted in less bleeding and fewer hospitalizations without significant differences in the incidence of ischemic events than regimens that included a vitamin K antagonist, aspirin, or both.
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| 56. |
- Lornudd, C., et al.
(författare)
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A champagne tower of influence : An interview study of how corporate boards enact occupational health and safety
- 2021
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Ingår i: Safety Science. - : Elsevier B.V.. - 0925-7535 .- 1879-1042. ; 143
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Tidskriftsartikel (refereegranskat)abstract
- The board of directors is responsible for governing organizations, including firms’ occupational health and safety (OHS). However, empirical research addressing how boards of directors enact OHS responsibility is scarce. In this study, we explored how boards of directors describe how their board acts to take responsibility for OHS. A secondary aim was to analyze whether those actions represent governance according to the agency theory and/or the stewardship theory. The empirical material consisted of 34 interviews with board members and chief executive officers in large private companies from four industries: trade, construction, manufacturing, and health/social care. Using Boardman and Lyon's framework for OHS governance, we conducted a hybrid thematic analysis. The findings deepen and broaden the current understanding of the role that the board of directors may play in OHS governance in private companies. The boards’ actions for taking responsibility for OHS both represent governance in line with the agency theory and stewardship theory. However, the boards’ actions also underpin a behavioral view of corporate OHS governance. This suggests an influence on the organization that starts with actions in the boardroom and, like champagne in a glass tower, trickles down from the executive directors to other layers of the organization.
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| 57. |
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| 58. |
- Mantovani, G, et al.
(författare)
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Recommendations for Diagnosis and Treatment of Pseudohypoparathyroidism and Related Disorders: An Updated Practical Tool for Physicians and Patients
- 2020
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Ingår i: Hormone research in paediatrics. - : S. Karger AG. - 1663-2826 .- 1663-2818. ; 93:3, s. 182-196
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Tidskriftsartikel (refereegranskat)abstract
- Patients affected by pseudohypoparathyroidism (PHP) or related disorders are characterized by physical findings that may include brachydactyly, a short stature, a stocky build, early-onset obesity, ectopic ossifications, and neurodevelopmental deficits, as well as hormonal resistance most prominently to parathyroid hormone (PTH). In addition to these alterations, patients may develop other hormonal resistances, leading to overt or subclinical hypothyroidism, hypogonadism and growth hormone (GH) deficiency, impaired growth without measurable evidence for hormonal abnormalities, type 2 diabetes, and skeletal issues with potentially severe limitation of mobility. PHP and related disorders are primarily clinical diagnoses. Given the variability of the clinical, radiological, and biochemical presentation, establishment of the molecular diagnosis is of critical importance for patients. It facilitates management, including prevention of complications, screening and treatment of endocrine deficits, supportive measures, and appropriate genetic counselling. Based on the first international consensus statement for these disorders, this article provides an updated and ready-to-use tool to help physicians and patients outlining relevant interventions and their timing. A life-long coordinated and multidisciplinary approach is recommended, starting as far as possible in early infancy and continuing throughout adulthood with an appropriate and timely transition from pediatric to adult care.
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| 59. |
- Milham, Michael P., et al.
(författare)
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An Open Resource for Non-human Primate Imaging
- 2018
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Ingår i: Neuron. - : Elsevier BV. - 0896-6273 .- 1097-4199. ; 100:1, s. 61-74
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Tidskriftsartikel (refereegranskat)abstract
- Non-human primate neuroimaging is a rapidly growing area of research that promises to transform and scale translational and cross-species comparative neuroscience. Unfortunately, the technological and methodological advances of the past two decades have outpaced the accrual of data, which is particularly challenging given the relatively few centers that have the necessary facilities and capabilities. The PRIMatE Data Exchange (PRIME-DE) addresses this challenge by aggregating independently acquired non-human primate magnetic resonance imaging (MRI) datasets and openly sharing them via the International Neuroimaging Data-sharing Initiative (INDI). Here, we present the rationale, design, and procedures for the PRIME-DE consortium, as well as the initial release, consisting of 25 independent data collections aggregated across 22 sites (total = 217 non-human primates). We also outline the unique pitfalls and challenges that should be considered in the analysis of non-human primate MRI datasets, including providing automated quality assessment of the contributed datasets.
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| 60. |
- Mosson, R., et al.
(författare)
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Exploring the role of line managers in implementing evidence-based practice in social services and older people care
- 2017
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Ingår i: British Journal of Social Work. - : Oxford University Press. - 0045-3102 .- 1468-263X. ; 47:2, s. 542-560
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Tidskriftsartikel (refereegranskat)abstract
- This qualitative study explored the vital role of line managers, namely the managerial level directly above employees, in effectively implementing evidence-based practice (EBP) from their own perspectives. Interviews were carried out with twenty-eight line managers within social services and older people care in seven Swedish municipalities. Thematic analysis was performed. Findings revealed that managers in social care perceived their role as important in implementing EBP. However, notable differences were observed between the two settings, where social services managers had more knowledge and held more positive attitudes towards working according to EBP, and described a more active role in the implementation process than managers in older people care. Overall, the implementation of EBP was performed ad hoc rather than systematically, and with little consideration to analysis of needs according to the local context and limited focus on follow-up and sustainability. This study highlighted that line managers in social services and older people care have different prerequisites for implementing EBP, and are greatly dependent on organisational strategies and context. Gaining knowledge of line managers' perceptions is essential for making informed decisions regarding the support required to achieve EBP in social care, and thus for providing the best possible care for clients.
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