| 1. |
- Ubachs, Joey, et al.
(author)
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Location of myocardium at risk in patients with first-time ST-elevation infarction: comparison among single photon emission computed tomography, magnetic resonance imaging, and electrocardiography.
- 2009
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In: Journal of Electrocardiology. - : Elsevier BV. - 1532-8430 .- 0022-0736. ; 42, s. 198-203
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Journal article (peer-reviewed)abstract
- BACKGROUND: The amount of myocardium at risk (MaR) during acute coronary occlusion and the duration of occlusion are important determinants of final infarct size. The main goal of early reperfusion therapy is to salvage ischemic myocardium, thereby preserving left ventricular function. The aims of the present study were to test the feasibility of developing polar plot representations of MaR, for perfusion single photon emission computed tomography (SPECT), regional wall thickening by magnetic resonance imaging (MRI), and distribution of ST-segment changes. A second aim was to test the hypothesis that these different modalities display similar localization of the MaR in patients with reperfused first-time myocardial infarction. METHODS: Eleven patients with first-time myocardial infarction with ST-elevation received (99m)Tc tetrofosmin before primary percutaneous coronary intervention, SPECT imaging within 3 hours, and cardiac MRI of the left ventricle within 24 hours. The results for SPECT, MRI, and electrocardiogram (ECG) were developed into polar plots, and two expert observers designated the culprit coronary artery as assessed by angiography. RESULTS: The perfusion SPECT, MRI wall thickening, and ST changes are presented in side-by-side polar plots. In total, the culprit artery, based on the location of the MaR, was correctly designated in 91%, 82%, and 91% of cases by SPECT, MRI, and ECG, respectively. CONCLUSIONS: Polar representation for localization of the MaR by SPECT perfusion, MRI wall thickening, and ECG ST-segment deviation is feasible. All 3 modalities have the potential to be used for indirect visual designation of the culprit artery in patients with first-time acute coronary occlusion.
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| 2. |
- Ferry, Tomas, et al.
(author)
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Epidemiology of acute knee injuries seen at the Emergency Department at Umeå University Hospital, Sweden, during 15 years
- 2014
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In: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer. - 0942-2056 .- 1433-7347. ; 22:5, s. 1149-1155
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Journal article (peer-reviewed)abstract
- PURPOSE: To describe the incidence and injury distribution of knee injuries in the general population of a European setting. METHODS: Retrospective study of all knee injuries registered at the Emergency Department at Umeå University Hospital, Sweden, during 1995-2009 in relation to age, sex, diagnosis, location and activity at the time of injury, mechanism of injury, and treatment and/or follow-up plan. RESULTS: During 1995-2009, 12,663 knee injuries were registered, 8 % of all injuries. The incidence of knee injuries resulting in a visit to the Emergency Department was six cases per 1,000 person years. One-third of all injuries occurred during sports. And 30 % were 15-24 years. More men than women were injured during sporting activities and women were mostly injured during transportation. CONCLUSION: Knee injuries in a general population are common and the injury distribution varies with age and sex. Sports activities and young age were prominent features of the injured population. LEVEL OF EVIDENCE: IV.
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| 3. |
- Granholm, Martina, 1969-
(author)
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Materialitetens roller och förutsättningar i kommunal krisledning
- 2019
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Licentiate thesis (other academic/artistic)abstract
- Arbetet med denna licentiatavhandling har skett inom ramarna för det Interregionalt finansierade projektet Gränslös samverkan för ökad säkerhet 2. Syftet med avhandlingen har varit att fördjupa kunskapen om kommunal krisledning genom att också inkludera materialitetens medverkan i krisledningen och vilka förutsättningarna är för att de ska brukas. Med perspektivet av hur analoga och digitala resurser används under krisledning och vilka förutsättningar som finns för att detta ska göras skapas insikter att ta i beaktande när övningar och IT-stöd för övningar. Studier har genomförts med en kvalitativ ansats med litteraturstudier, intervjuer och observationer som datainsamlingsmetoder. Det empiriska materialet har därefter betraktats med meningsgivande (sensemaking) och affordans (affordance) som teoretiska perspektiv för att förstå materialitetens roll och förutsättning i kommunal krisledning.Avhandlingen visar att de förmågor som är återkommande under övningar är samverkan, kommunikation, informationsdelning och skapande av lägesbild. Ofta övas inte aktiviteterna i sin helhet då tekniska och analoga resurser inte innefattas i övningarna. Aktörerna övar därmed delar av görandet, att tänka kring exempelvis att skapa en lägesbild, och inte görandet som helhet som involverar materialitet. Aktörernas egna reflektioner från utvärderingarna är att de själva önskar mer övning med de tekniska resurser som de har till sitt förfogande. Artikel II visar att materialiteten tar en stor plats i det arbete som sker i krisledningsrummet. Materialiteten kan ses anta roller som strukturgivande, meningsgivande, tidsöverbryggande och distansöverbryggande. Den tredje ingående artikeln visar att förutsättningar för att kunna bedriva krisledning är att kunna hantera materialitetens roller och att det krävs flexibilitet då krisledningsgruppens sammansättning är beroende av krisens art och omfattning. Ytterligare en förutsättning är trygghet i den egna organisationen, att känna sin egen roll i krisledningsgruppen och att kunna hantera de analoga och digitala resurser som finns tillgängliga är även det en förutsättning för arbetet. Avslutningsvis visar arbetet också att tid är viktig. Tid att kunna öva de personer som ska ingå i krisledningsgruppen för att därmed kunna skapa den trygghet som behövs.
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| 4. |
- Hedström, Erik M, et al.
(author)
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Epidemiology of fractures in children and adolescents
- 2010
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In: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 81:1, s. 148-153
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Journal article (peer-reviewed)abstract
- Background and purpose Fractures are most common in youth and in the elderly, with differences in incidence over time and between regions. We present the fracture pattern in a population of youths ≤ 19 years of age, who were seen at Umeå University Hospital, Sweden. Material and methods All injuries seen at the hospital have been recorded in a database since 1993. The data include variables such as age, sex, date, type of injury, mechanism of injury, and treatment. For the period 1993–2007, there were 10,203 injury events that had resulted in at least 1 fracture. Results The incidence for the whole period was 201/104 person years. The incidence increased by 13% during the period 1998–2007, when we were able to control for registration errors. The most common fracture site was the distal forearm. The most common type of injury mechanism was falling. The peak incidence occurred at 11–12 years in girls and at 13–14 years in boys, with a male-to-female incidence ratio of 1.5. We found variations in mechanisms and activities at injury with age, and over time. Interpretation Fractures are caused by a combination of intrinsic and extrinsic factors that vary with age. We believe the increase in incidence is partly explained by changes in children's activity patterns over time. Further research may help to identify preventive measures to reduce the number of fractures, in particular those involving hospital care, surgical treatment, and—most importantly—long-term impairment. Read More: http://informahealthcare.com/doi/abs/10.3109/17453671003628780
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| 5. |
- Hedström, Erik M, et al.
(author)
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Epidemiology of fractures in children and adolescents : Increased incidence over the past decade: a population-based study from northrn Sweden
- 2010
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In: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 81:1, s. 148-153
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Journal article (peer-reviewed)abstract
- Background and purpose Fractures are most common in youth and in the elderly, with differences in incidence over time and between regions. We present the fracture pattern in a population of youths <= 19 years of age, who were seen at Umeå University Hospital, Sweden. Material and methods All injuries seen at the hospital have been recorded in a database since 1993. The data include variables such as age, sex, date, type of injury, mechanism of injury, and treatment. For the period 1993-2007, there were 10,203 injury events that had resulted in at least 1 fracture. Results The incidence for the whole period was 201/104 person years. The incidence increased by 13% during the period 1998-2007, when we were able to control for registration errors. The most common fracture site was the distal forearm. The most common type of injury mechanism was falling. The peak incidence occurred at 11-12 years in girls and at 13-14 years in boys, with a male-to-female incidence ratio of 1.5. We found variations in mechanisms and activities at injury with age, and over time. Interpretation Fractures are caused by a combination of intrinsic and extrinsic factors that vary with age. We believe the increase in incidence is partly explained by changes in children's activity patterns over time. Further research may help to identify preventive measures to reduce the number of fractures, in particular those involving hospital care, surgical treatment, and-most importantly-long-term impairment.
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| 6. |
- Hedström, Erik M, et al.
(author)
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Injuries in children and adolescents : analysis of 41,330 injury related visits to an emergency department in northern Sweden
- 2012
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In: Injury. - : Elsevier. - 0020-1383 .- 1879-0267. ; 43:9, s. 1403-1408
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Journal article (peer-reviewed)abstract
- Objectives: We present an overview of the injuries seen at the emergency department of a regional hospital in northern Sweden and the variations in the injury pattern with age, sex and time. Methods: Data consisting of all injuries sustained by those 0–19 years of age seen at the emergency department of Umeå University Hospital between 1998 and 2008 (41,330 injury events) were analysed with respect to injury type, mechanism, activity, age and sex. Rates were calculated using population data from Statistics Sweden. Results: The rate of injury related visits to the emergency department was 110/1000 person years. The most common causes of visits to the emergency department were minor injuries such as contusions, abrasions and open wounds. 12% of the injuries resulted in admission to a ward. Variations in type of injury, mechanism and activity at injury were noted, in particular with age, but also with sex. We noted a 31% rate increase of visits to the hospital's emergency department between 1998 and 2008, rate ratio 1.31 (1.27–1.38). There was no significant increase in the rate of injuries resulting in hospitalisation. Conclusions: Our results give an estimate of the rate of all injuries and subsets of injuries resulting in visits to the only hospital emergency department within a well defined catchment area. It was not possible to determine whether the increased rate of visits to the ED was due to an increase in the actual rate of injuries within the catchment area. The variations seen in different age groups reflect the hazards associated with different periods in growth and the ability to cope with these. The results point to areas where improved preventive measures may be implemented or where further research may be of value
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| 7. |
- Knippenberg, Stephanie A. M., et al.
(author)
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Consideration of the Impact of Reperfusion Therapy on the Quantitative Relationship between the Selvester QRS Score and Infarct Size by Cardiac MRI
- 2010
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In: Annals of Noninvasive Electrocardiology. - 1082-720X. ; 15:3, s. 238-244
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Journal article (peer-reviewed)abstract
- Methods: Twenty-seven patients with acute first-time reperfused MI were studied. Infarct size was determined by delayed contrast-enhanced magnetic resonance imaging (DE-MRI) and estimated with the 50-criteria/31-point Selvester QRS scoring system 1 week after admission. The findings in the present study were compared with previous postmortem studies exploring the quantitative relationship between Selvester QRS score and MI size in nonreperfused patients. Results: The quantitative relationship between QRS score and MI size by DE-MRI in the present study of early reperfused MI was significantly different from previous postmortem histopathology studies of nonreperfused MI (P < 0.0001). In the present study, each QRS point represented approximately 2% of the left ventricle, compared to approximately 3% in previous postmortem histopathology studies of nonreperfused MI. When only considering small to moderate MI sizes, there was no significant difference in the quantitative relationship between QRS score and infarct size (P > 0.05). Conclusions: There is a different quantitative relationship between QRS score and MI size in early reperfused MI compared to nonreperfused MI, partly explained by differences in MI size. Thus, the Selvester QRS scoring system may not be linearly related to MI size. Ann Noninvasive Electrocardiol 2010;15(3):238-244.
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