| 1. |
|
|
| 2. |
|
|
| 3. |
- Hasselqvist-Ax, Ingela, et al.
(author)
-
Dispatch of Firefighters and Police Officers in Out-of-Hospital Cardiac Arrest : A Nationwide Prospective Cohort Trial Using Propensity Score Analysis.
- 2017
-
In: Journal of the American Heart Association. - 2047-9980. ; 6:10
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Dispatch of basic life support-trained first responders equipped with automated external defibrillators in addition to advanced life support-trained emergency medical services personnel in out-of-hospital cardiac arrest (OHCA) has, in some minor cohort studies, been associated with improved survival. The aim of this study was to evaluate the association between basic life support plus advanced life support response and survival in OHCA at a national level.METHODS AND RESULTS: This prospective cohort study was conducted from January 1, 2012, to December 31, 2014. People who experienced OHCA in 9 Swedish counties covered by basic life support plus advanced life support response were compared with a propensity-matched contemporary control group of people who experienced OHCA in 12 counties where only emergency medical services was dispatched, providing advanced life support. Primary outcome was survival to 30 days. The analytic sample consisted of 2786 pairs (n=5572) derived from the total cohort of 7308 complete cases. The median time from emergency call to arrival of emergency medical services or first responder was 9 minutes in the intervention group versus 10 minutes in the controls (P<0.001). The proportion of patients admitted alive to the hospital after resuscitation was 31.4% (875/2786) in the intervention group versus 24.9% (694/2786) in the controls (conditional odds ratio, 1.40; 95% confidence interval, 1.24-1.57). Thirty-day survival was 9.5% (266/2786) in the intervention group versus 7.7% (214/2786) in the controls (conditional odds ratio, 1.27; 95% confidence interval, 1.05-1.54).CONCLUSIONS: In this nationwide interventional trial, using propensity score matching, dispatch of first responders in addition to emergency medical services in OHCA was associated with a moderate, but significant, increase in 30-day survival.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02184468.
|
|
| 4. |
- Ingelsson, Erik, et al.
(author)
-
Diurnal blood pressure pattern and risk of congestive heart failure
- 2006
-
In: Journal of the American Medical Association (JAMA). - 0098-7484 .- 1538-3598. ; 295:24, s. 2859-2866
-
Journal article (peer-reviewed)abstract
- CONTEXT: High blood pressure is the most important risk factor for congestive heart failure (CHF) at a population level, but the relationship of an altered diurnal blood pressure pattern to risk of subsequent CHF is unknown. OBJECTIVES: To explore 24-hour ambulatory blood pressure characteristics as predictors of CHF incidence and to investigate whether altered diurnal blood pressure patterns confer any additional risk information beyond that provided by conventional office blood pressure measurements. DESIGN, SETTING, AND PARTICIPANTS: Prospective, community-based, observational cohort in Uppsala, Sweden, including 951 elderly men free of CHF, valvular disease, and left ventricular hypertrophy at baseline between 1990 and 1995, followed up until the end of 2002. Twenty-four-hour ambulatory blood pressure monitoring was performed at baseline, and the blood pressure variables were analyzed as predictors of subsequent CHF. MAIN OUTCOME MEASURE: First hospitalization for CHF. RESULTS: Seventy men developed heart failure during follow-up, with an incidence rate of 8.6 per 1000 person-years at risk. In multivariable Cox proportional hazards models adjusted for antihypertensive treatment and established risk factors for CHF (myocardial infarction, diabetes, smoking, body mass index, and serum cholesterol level), a 1-SD (9-mm Hg) increase in nighttime ambulatory diastolic blood pressure (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.02-1.55) and the presence of "nondipping" blood pressure (night-day ambulatory blood pressure ratio > or =1; HR, 2.29; 95% CI, 1.16-4.52) were associated with an increased risk of CHF. After adjusting for office-measured systolic and diastolic blood pressures, nondipping blood pressure remained a significant predictor of CHF (HR, 2.21; 95% CI, 1.12-4.36 vs normal night-day pattern). Nighttime ambulatory diastolic blood pressure and nondipping blood pressure were also significant predictors of CHF after exclusion of all participants who had an acute myocardial infarction before baseline or during follow-up. CONCLUSIONS: Nighttime blood pressure appears to convey additional risk information about CHF beyond office-measured blood pressure and other established risk factors for CHF. The clinical value of this association remains to be established in future studies.
|
|
| 5. |
- Lithell, Hans, et al.
(author)
-
Epidemiological and clinical studies on insulin resistance and diabetes
- 2000
-
In: Upsala Journal of Medical Sciences. - 0300-9734. ; 105:2, s. 135-150
-
Journal article (pop. science, debate, etc.)abstract
- In Uppsala, extensive epidemiological and clinical studies on insulin resistance and diabetes have been ongoing for the past 30 years. A prospective cohort study of men born 1920-24, living in Uppsala County, was initiated during 1969-74 (the Uppsala Longitudinal Study of Adult Men, ULSAM). Risk factors for cardiovascular disease were examined in 2,322 men, and re-examinations have been performed every 10 years. At the first follow-up, when the men were 60 years old, insulin resistance was found to be a risk factor for development of hypertension and diabetes. In addition, treatment with antihypertensive medication was an independent risk factor for development of diabetes. These findings resulted in a series of clinical studies on metabolic effects of antihypertensive agents. At the second follow-up, when the men were 70 years old, the development of hypertension and diabetes was once again in focus, but at this time, cross-sectional and prospective studies of other cardiovascular determinants, such as circadian blood pressure pattern, left ventricular geometry and function, muscle morphology, ion status, fibrinolysis and cognitive function, were also performed. The cohort has furthermore been linked to the Swedish census and hospital discharge and cause of death registries, it has been used for studies on relationships between birth weight and cardiovascular disease, and genetic analyses have been performed, taking advantage of the long observation time obtained in this cohort. The cohort is currently being re-examined for the third time, and will hopefully continue to provide valuable information on the epidemiology of diabetes and cardiovascular disease in the future.
|
|
| 6. |
- Plink Björklund, Piret, 1969, et al.
(author)
-
Sedimentary documentation of the break-up of Rodinia, Offerdal Nappe, Swedish Caledonides
- 2005
-
In: Precambrian Research. - : Elsevier BV. - 0301-9268. ; 136:1, s. 1-26
-
Journal article (peer-reviewed)abstract
- Late Riphean to early Vendian metasedimentary rocks of the Offerdal Nappe, central Scandinavian Caledonides, were studied by field mapping and measured sections. Even though the rocks have been metamorphosed and tectonically deformed, preserved sedimentary structures and outcrop exposure permit the interpretation of a little-known area with respect to the break-up of Rodinia. This work shows that although the primary sedimentary textures are strongly altered during metamorphism the primary sedimentary structures and bed geometries are commonly preserved. Moreover, the sedimentary structures, where identified, can be used to hydrodynamically estimate the primary grain-size of the metasedimentary rocks. Seven sedimentary facies, were identified in three tectonostratigraphic units. The lower tectonostratigraphic unit consists of polymict conglomerates deposited in alluvial fans. The lower part of the middle tectonostratigraphic unit consists of channelled turbidite deposits. The upper part of the middle tectonostratigraphic unit consists of a regressive to transgressive succession with southeast to northwest transition from fluvial deposits, to storm-dominated deposits and into offshore mudstones. The lower part of the upper tectonostratigraphic unit consists of a regressive succession with southeast to northwest transition from channelled turbidites into sheet-like turbidites. The upper part consists of fluvial deposits in updip (southeast) areas, whereas in downdip (northwest) areas the sheet-like turbidites reflect continued deepwater deposition. (1) The similar to 1500 in thickness of the Offerdal succession, (2) the occurrence of > 300 m thickness of the pebble- to boulder-bearing continental-basement derived alluvial fan conglomerates, (3) the high sediment input rates, and (4) the high subsidence rates suggest an actively subsiding basin and a relatively uplifted hinterland. Furthermore, the arkosic composition of the Offerdal metasandstones, as well as the Precambrian porphyry, syenite and quartzite clast composition of the lithic conglomerates, recognised from the subjacent continental basement of Baltica, suggest a continental sediment source. The rapid accommodation changes, and especially the simultaneous subsidence of downdip areas and uplift of updip areas in UTU2 suggest syn-depositional extensional block rotation. Collectively, this evidence suggests that the Offerdal succession was deposited in a continental rift basin related to break-up of Rodinia. (C) 2004 Elsevier B.V. All rights reserved.
|
|
| 7. |
|
|
| 8. |
- Ahnström, Johan, et al.
(author)
-
Farmers' Interest in Nature and Its Relation to Biodiversity in Arable Fields
- 2013
-
In: International Journal of Ecology. - : Hindawi Publishing Corporation. - 1687-9708 .- 1687-9716.
-
Journal article (peer-reviewed)abstract
- Biodiversity declines in farmland have been attributed to intensification of farming at the field level and loss of heterogeneity at the landscape level. However, farmers are not solely optimizing production; their actions are also influenced by social factors, tradition and interest in nature, which indirectly influence biodiversity but rarely are incorporated in studies of farmland biodiversity. We used social science methods to quantify farmers’ interest in nature on 16 farms with winter wheat fields in central Sweden, and combined this with biodiversity inventories of five organism groups (weeds, carabid beetles, bumblebees, solitary bees, and birds) and estimates of landscape composition andmanagement intensity at the field level.Agricultural intensity,measured as crop density, and farmers’ interest in nature explained variation in biodiversity, measured as the proportion of the regional species richness found on single fields. Interest in nature seemed to incorporate many actions taken by farmers and appeared to be influenced by both physical factors, for example, the surrounding landscape, and social factors, for example, social motivations.This study indicates that conservation of biodiversity in farmland, and design of new agri-environmental subsidy systems, would profit from taking farmers’ interest in nature and its relation to agricultural practices into account.
|
|
| 9. |
|
|
| 10. |
- Albèr, Cathrine, et al.
(author)
-
Effects of water gradients and use of urea on skin ultrastructure evaluated by confocal Raman microspectroscopy
- 2013
-
In: Biochimica et Biophysica Acta - Biomembranes. - : Elsevier. - 0005-2736 .- 1879-2642 .- 0006-3002. ; 1828:11, s. 2470-2478
-
Journal article (peer-reviewed)abstract
- The rather thin outermost layer of the mammalian skin, stratum corneum (SC), is a complex biomembrane which separates the water rich inside of the body from the dry outside. The skin surface can be exposed to rather extreme variations in ambient conditions (e.g. water activity, temperature and pH), with potential effects on the barrier function. Increased understanding of how the barrier is affected by such changes is highly relevant for regulation of transdermal uptake of exogenous chemicals. In the present study we investigate the effect of hydration and the use of a well-known humectant, urea, on skin barrier ultrastructure by means of confocal Raman microspectroscopy. We also perform dynamic vapor sorption (DVS) microbalance measurements to examine the water uptake capacity of SC pretreated with urea. Based on novel Raman images, constructed from 2D spectral maps, we can distinguish large water inclusions within the skin membrane exceeding the size of fully hydrated corneocytes. We show that these inclusions contain water with spectral properties similar to that of bulk water. The results furthermore show that the ambient water activity has an important impact on the formation of these water inclusions as well as on the hydration profile across the membrane. Urea significantly increases the water uptake when present in skin, as compared to skin without urea, and it promotes formation of larger water inclusions in the tissue. The results confirm that urea can be used as a humectant to increase skin hydration.
|
|
| 11. |
|
|
| 12. |
- Arwehed, Sofia, et al.
(author)
-
Nordic survey showed wide variation in discharge practices for very preterm infants
- 2023
-
In: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227.
-
Journal article (peer-reviewed)abstract
- AimWe aimed to describe clinical practices and criteria for discharge of very preterm infants in Nordic neonatal units.MethodsMedical directors of all 89 level-2 and level-3 units in Denmark, Finland, Iceland, Norway and Sweden were invited by e-mail to complete a web-based multiple-choice survey with the option to make additional free-text comments.ResultsWe received responses from 83/89 units (93%). In all responding units, discharge readiness was based mainly on clinical assessment with varying criteria. In addition, 36% used formal tests of cardiorespiratory stability and 59% used criteria related to infant weight or growth. For discharge with feeding tube, parental ability to speak the national language or English was mandatory in 45% of units, with large variation among countries. Post-discharge home visits and video-consultations were provided by 59% and 51%, respectively. In 54% of units, parental preparation for discharge were not initiated until the last two weeks of hospital stay.ConclusionDischarge readiness was based mainly on clinical assessment, with criteria varying among units despite similar population characteristics and care structures. This variation indicates a lack of evidence base and may unnecessarily delay discharge; further studies of this matter are needed. Earlier parental preparation and use of interpreters might facilitate earlier discharge.
|
|
| 13. |
- Bechshoft, Thea, et al.
(author)
-
Developing a new research tool for use in free-ranging cetaceans : recovering cortisol from harbour porpoise skin
- 2015
-
In: Conservation Physiology. - 2051-1434. ; 3
-
Journal article (peer-reviewed)abstract
- We developed a chemical analytical procedure for sampling, extracting and determining epidermal skin cortisol concentrations (SCCs) in the harbour porpoise (Phocoena phocoena) using gas chromatography–tandem mass spectrometry. In brief, this involved a pressurized liquid extraction with a two-step solid-phase clean-up. A derivatization step was conducted prior to detection. To evaluate the new assay, cortisol was analysed in three different sample types obtained from four harbour porpoises: skin plates, dorsal fin skin plugs (with and without lidocaine) and epidermal scrapes. Skin cortisol concentrations could be measured using the new assay in the majority of the tested skin samples down to a minimal sample size of 49 mg dry weight (dw). Water content ranged from 10 to 46% in the plug samples, which had SCCs from 2.1 to 77.7 ng/g dw. Epidermal scrape samples had the highest water content (83–87%) and lower SCCs (0.6–15 ng/g dw), while the skin plates had intermediate water contents (60–66%) and SCCs of 2.6–13.0 ng/g dw. SCC was slightly higher in plugs with lidocaine than without (average values of 41 and 33 ng/g dw, respectively). Substantial within-individual variations in cortisol concentrations are also common in other matrices such as blood and hair. Some important factors behind this variation could be e.g. the animal's sex, age, body condition, reproductive stage, and the body region sampled, as well as season, moulting cycles and water temperature. Clearly, more research into SCCs is required. The findings described here represent the first critical steps towards using epidermal skin cell samples to assess chronic stress levels in cetaceans and the development of a widely applicable health-assessment tool in these species.
|
|
| 14. |
- Bechshoft, Thea, et al.
(author)
-
Developing a new research tool for use in free-ranging cetaceans : recovering cortisol from harbour porpoise skin
- 2015
-
In: Conservation Physiology. - : Oxford University Press. - 2051-1434. ; 3
-
Journal article (peer-reviewed)abstract
- We developed a chemical analytical procedure for sampling, extracting and determining epidermal skin cortisol concentrations (SCCs) in the harbour porpoise (Phocoena phocoena) using gas chromatography–tandem mass spectrometry. In brief, this involved a pressurized liquid extraction with a two-step solid-phase clean-up. A derivatization step was conducted prior to detection. To evaluate the new assay, cortisol was analysed in three different sample types obtained from four harbour porpoises: skin plates, dorsal fin skin plugs (with and without lidocaine) and epidermal scrapes. Skin cortisol concentrations could be measured using the new assay in the majority of the tested skin samples down to a minimal sample size of 49 mg dry weight (dw). Water content ranged from 10 to 46% in the plug samples, which had SCCs from 2.1 to 77.7 ng/g dw. Epidermal scrape samples had the highest water content (83–87%) and lower SCCs (0.6–15 ng/g dw), while the skin plates had intermediate water contents (60–66%) and SCCs of 2.6–13.0 ng/g dw. SCC was slightly higher in plugs with lidocaine than without (average values of 41 and 33 ng/g dw, respectively). Substantial within-individual variations in cortisol concentrations are also common in other matrices such as blood and hair. Some important factors behind this variation could be e.g. the animal's sex, age, body condition, reproductive stage, and the body region sampled, as well as season, moulting cycles and water temperature. Clearly, more research into SCCs is required. The findings described here represent the first critical steps towards using epidermal skin cell samples to assess chronic stress levels in cetaceans and the development of a widely applicable health-assessment tool in these species.
|
|
| 15. |
- Beziat, Vivien, et al.
(author)
-
NK cell responses to cytomegalovirus infection lead to stable imprints in the human KIR repertoire and involve activating KIRs
- 2013
-
In: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 121:14, s. 2678-2688
-
Journal article (peer-reviewed)abstract
- Human natural killer (NK) cells are functionally regulated by killer cell immunoglobulin-like receptors (KIRs) and their interactions with HLA class I molecules. As KIR expression in a given NK cell is genetically hard-wired, we hypothesized that KIR repertoire perturbations reflect expansions of unique NK-cell subsets and may be used to trace adaptation of the NK-cell compartment to virus infections. By determining the human KIR-ome at a single-cell level in more than 200 donors, we were able to analyze the magnitude of NK cell adaptation to virus infections in healthy individuals. Strikingly, infection with human cytomegalovirus (CMV), but not with other common herpesviruses, induced expansion and differentiation of KIR-expressing NK cells, visible as stable imprints in the repertoire. Education by inhibitory KIRs promoted the clonal-like expansion of NK cells, causing a bias for self-specific inhibitory KIRs. Furthermore, our data revealed a unique contribution of activating KIRs (KIR2DS4, KIR2DS2, or KIR3DS1), in addition to NKG2C, in the expansion of human NK cells. These results provide new insight into the diversity of KIR repertoire and its adaptation to virus infection, suggesting a role for both activating and inhibitory KIRs in immunity to CMV infection.
|
|
| 16. |
- Björklund, Camilla, et al.
(author)
-
Matematikkundervisning
- 2013
-
Book (other academic/artistic)abstract
- Denna boken är skriven av en grupp erfarna norska och svenska lärarutbildare i matematik. Boken bygger på utprövad erfarenhet - såväl egen som andras - och på aktuell, relevant forskning i matematikdidaktik. Texten väver samman matematik och matematikdidaktik, det vill säga ämnet som det undervisas i och frågor om hur ämnet kan läras och undervisas. Boken innehåller det som är absolut viktigast att få med sig i den grundläggande lärarutbildningen i matmatik.
|
|
| 17. |
- Björklund, Erik, et al.
(author)
-
Comparison of Midterm Outcomes Associated With Aspirin and Ticagrelor vs Aspirin Monotherapy After Coronary Artery Bypass Grafting for Acute Coronary Syndrome.
- 2021
-
In: JAMA network open. - : American Medical Association (AMA). - 2574-3805. ; 4:8
-
Journal article (peer-reviewed)abstract
- Guidelines recommend dual antiplatelet therapy after coronary artery bypass grafting (CABG) for patients with acute coronary syndrome (ACS). However, the evidence for these recommendations is weak.To compare midterm outcomes after CABG in patients with ACS treated postoperatively with acetylsalicylic acid (ASA) and ticagrelor or with ASA monotherapy.This cohort study used merged data from several national registries of Swedish patients who were diagnosed with ACS and subsequently underwent CABG. All included patients underwent isolated CABG in Sweden between 2012 and 2017 with an ACS diagnosis less than 6 weeks before the procedure, survived 14 days after discharge from hospital, and were treated postoperatively with ASA plus ticagrelor or ASA monotherapy. A multivariable Cox regression model was used for the main analysis, and propensity score-matched models were performed as sensitivity analysis. Data were analyzed between May and September 2020.Postoperative antiplatelet treatment, defined as filled prescriptions, with either ASA and ticagrelor or ASA only.Major adverse cardiovascular events (MACE), defined as all-cause mortality, myocardial infarction, and stroke, and major bleeding, at 12 months and at the end of follow-up.A total of 6558 patients (5281 [80.5%] men; mean [SD] age at surgery, 67.6 [9.3] years) were included; 1813 (27.6%) were treated with ASA plus ticagrelor and 4745 (72.4%) were treated with ASA monotherapy. Crude MACE rate was 3.0 per 100 person years (95% CI, 2.5-3.6 per 100 person years) in the ASA plus ticagrelor group and 3.8 per 100 person years (95% CI, 3.5-4.1 per 100 person years) in the ASA group. After adjustment, there was no significant difference in MACE risk between ASA plus ticagrelor vs ASA only, neither during the first 12 months (adjusted hazard ratio [aHR], 0.84; 95% CI, 0.58-1.21; P=.34) or during total follow-up (aHR, 0.89; 95% CI, 0.71-1.11; P=.29). The use of ASA plus ticagrelor was associated with a significantly increased risk for major bleeding during the first 12 months (aHR, 1.90; 95% CI, 1.16-3.13; P=.011). Sensitivity analyses confirmed the results.In patients with ACS who survived 2 weeks after CABG, no significant difference in the risk of death or ischemic events could be demonstrated between ASA plus ticagrelor and patients treated with ASA only, while the risk for major bleeding was higher in patients treated with ASA plus ticagrelor. Sufficiently powered prospective randomized trials comparing different antiplatelet therapy strategies after CABG are warranted.
|
|
| 18. |
- Björklund, Erik, et al.
(author)
-
Postdischarge major bleeding, myocardial infarction, and mortality risk after coronary artery bypass grafting
- 2023
-
In: HEART. - 1355-6037 .- 1468-201X.
-
Journal article (peer-reviewed)abstract
- Objective To investigate the incidence and mortality risk associated with postdischarge major bleeding after coronary artery bypass grafting (CABG), and relate this to the incidence of, and mortality risk from, postdischarge myocardial infarction.Methods All patients undergoing first-time isolated CABG in Sweden in 2006-2017 and surviving 14 days after hospital discharge were included in a cohort study. Individual patient data from the SWEDEHEART Registry and five other mandatory nationwide registries were merged. Piecewise Cox proportional hazards models were used to investigate associations between major bleeding, defined as hospitalisation for bleeding, with subsequent mortality risk. Similar Cox proportional hazards models were used to investigate the association between postdischarge myocardial infarction and mortality risk.Results Among 36 633 patients, 2429 (6.6%) had a major bleeding event and 2231 (6.1%) had a myocardial infarction. Median follow-up was 6.0 (range 0-11) years. Major bleeding was associated with higher mortality risk <30 days (adjusted HR (aHR)=20.2 (95% CI 17.3 to 23.5)), 30-365 days (aHR=3.8 (95% CI 3.4 to 4.3)) and >365 days (aHR=1.8 (95% CI 1.7 to 2.0)) after the event. Myocardial infarction was associated with higher mortality risk <30 days (aHR=20.0 (95% CI 16.7 to 23.8)), 30-365 days (aHR=4.1 (95% CI 3.6 to 4.8)) and >365 days (aHR=1.8 (95% CI 1.7 to 2.0)) after the event.Conclusions The increase in mortality risk associated with a postdischarge major bleeding after CABG is substantial and is similar to the mortality risk associated with a postdischarge myocardial infarction.
|
|
| 19. |
- Björklund, Erik, et al.
(author)
-
Postoperative platelet function is associated with severe bleeding in ticagrelor-treated patients
- 2019
-
In: Interactive Cardiovascular and Thoracic Surgery. - : Oxford University Press (OUP). - 1569-9293 .- 1569-9285. ; 28:5, s. 709-715
-
Journal article (peer-reviewed)abstract
- Objectives: Preoperative testing of platelet function predicts bleeding risk in cardiac surgery patients treated with dual antiplatelet therapy, but the value of postoperative platelet function testing, reflecting both preoperative antiplatelet therapy and perioperative changes in platelet function, has not been evaluated. Methods: Seventy-four patients with acute coronary syndrome treated with acetylsalicylic acid and ticagrelor within 5 days before cardiac surgery were included in a prospective observational study. Platelet aggregation induced by adenosine diphosphate, arachidonic acid and thrombin receptor-activating peptide was assessed with multiple electrode impedance aggregometry immediately before surgery and 2 h after weaning off cardiopulmonary bypass. Receiver operating characteristic curves were used to determine any association between platelet aggregation and severe bleeding according to the universal definition of perioperative bleeding in adult cardiac surgery. Results: Severe bleeding occurred in 25 of 74 patients (34%). Preoperative and postoperative adenosine diphosphate-induced platelet aggregations were associated with bleeding, with comparable areas under the receiver operating characteristic curve [0.77 (95% confidence interval 0.65-0.89) vs 0.75 (0.62-0.87)]. Postoperative arachidonic acid-and thrombin receptor-activating peptide-induced aggregation had markedly smaller areas under the curve. There were significant correlations between preoperative and postoperative platelet aggregation induced by adenosine diphosphate (r2 = 0.77, P < 0.001), arachidonic acid (r2 = 0.24, P < 0.001) and thrombin receptoractivating peptide (r2 = 0.21, P < 0.001) but with large interindividual variations. Conclusions: Poor postoperative platelet function was associated with severe bleeding, with accuracy comparable to that of preoperative platelet function. There was a correlation between preoperative and postoperative platelet function, but the predictability in an individual patient was limited. © 2018 The Author(s). Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
|
|
| 20. |
- Björklund, Erik, et al.
(author)
-
Pre-hospital thrombolysis delivered by paramedics is associated with reduced time delay and mortality in ambulance-transported real-life patients with ST-elevation myocardial infarction
- 2006
-
In: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 27:10, s. 1146-1152
-
Journal article (peer-reviewed)abstract
- AIMS: There are sparse data on the impact of pre-hospital thrombolysis (PHT) in real-life patients. We therefore evaluated treatment delays and outcome in a large cohort of ambulance-transported real-life patients with ST-elevation myocardial infarction (STEMI) according to PHT delivered by paramedics or in-hospital thrombolysis. METHODS AND RESULTS: Prospective cohort study used data from the Swedish Register of Cardiac intensive care on patients admitted to the coronary care units of 75 Swedish hospitals in 2001-2004. Ambulance-transported thrombolytic-treated patients younger than age 80 with a diagnosis of acute myocardial infarction were included. Patients with PHT (n=1690) were younger, had a lower prevalence of co-morbid conditions, fewer complications, and a higher ejection fraction (EF) than in-hospital-treated patients (n=3685). Median time from symptom onset to treatment was 113 min for PHT and 165 min for in-hospital thrombolysis. One-year mortality was 7.2 vs. 11.8% for PHT and in-hospital thrombolysis, respectively. In a multivariable analysis, after adjusting for baseline characteristics and rescue angioplasty, PHT was associated with lower 1-year mortality (odds ratio 0.71, 0.55-0.92, P=0.008). CONCLUSION: When compared with regular in-hospital thrombolysis, pre-hospital diagnosis and thrombolysis with trained paramedics in the ambulances are associated with reduced time to thrombolysis by almost 1 h and reduced adjusted 1-year mortality by 30% in real-life STEMI patients.
|
|
| 21. |
|
|
| 22. |
|
|
| 23. |
- Björklund, Erik, et al.
(author)
-
Secondary prevention medications after coronary artery bypass grafting and long-term survival : a population-based longitudinal study from the SWEDEHEART registry.
- 2019
-
In: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 41:17, s. 1653-1661
-
Journal article (peer-reviewed)abstract
- AIMS: To evaluate the long-term use of secondary prevention medications [statins, β-blockers, renin-angiotensin-aldosterone system (RAAS) inhibitors, and platelet inhibitors] after coronary artery bypass grafting (CABG) and the association between medication use and mortality.METHODS AND RESULTS: All patients who underwent isolated CABG in Sweden from 2006 to 2015 and survived at least 6 months after discharge were included (n = 28 812). Individual patient data from SWEDEHEART and other mandatory nationwide registries were merged. Multivariable Cox regression models using time-updated data on dispensed prescriptions were used to assess associations between medication use and long-term mortality. Statins were dispensed to 93.9% of the patients 6 months after discharge and to 77.3% 8 years later. Corresponding figures for β-blockers were 91.0% and 76.4%, for RAAS inhibitors 72.9% and 65.9%, and for platelet inhibitors 93.0% and 79.8%. All medications were dispensed less often to patients ≥75 years. Treatment with statins [hazard ratio (HR) 0.56, 95% confidence interval (95% CI) 0.52-0.60], RAAS inhibitors (HR 0.78, 95% CI 0.73-0.84), and platelet inhibitors (HR 0.74, 95% CI 0.69-0.81) were individually associated with lower mortality risk after adjustment for age, gender, comorbidities, and use of other secondary preventive drugs (all P < 0.001). There was no association between β-blockers and mortality risk (HR 0.97, 95% CI 0.90-1.06; P = 0.54).CONCLUSION: The use of secondary prevention medications after CABG was high early after surgery but decreased significantly over time. The results of this observational study, with inherent risk of selection bias, suggest that treatment with statins, RAAS inhibitors, and platelet inhibitors is essential after CABG whereas the routine use of β-blockers may be questioned.
|
|
| 24. |
|
|
| 25. |
- Björklund, Gunilla, 1973-, et al.
(author)
-
Säkerhet och trygghet på pendeltågsstationer
- 2024
-
In: Sammanställning av referat från Transportforum 2024. - Linköping : Statens väg- och transportforskningsinstitut. ; , s. 110-111-
-
Conference paper (other academic/artistic)abstract
- Obehöriga spårbeträdanden kan leda till allvarliga personskador och är dessutom mycket punktlighetsstörande för järnvägssystemet. En del stationer har omfattande problem med obehöriga i spår. Att rikta åtgärder mot stationsområden är därför viktigt för att minska antalet skadade och omkomna i järnvägssystemet och för att öka punktligheten. Inom det branschövergripande arbetet Tillsammans för Tåg i Tid pekade man ut pendeltågsstationerna Årstaberg, Upplands Väsby och Järna som belastade platser.Syften med den här studien var att:studera säkerheten på de tre stationerna ovan samt att studera resenärers och personals förslag på vad som kan förbättras på dessa stationer. Vi studerade även tryggheten på stationerna.Utvärdera de fysiska åtgärder som Trafikverket genomför på de tre stationerna under projektets tidsram. Även Södra station studerades.I denna presentation kommer endast resultat från det första syftet presenteras. I projektet har följande aktiviteter genomförts:Platsbesök på stationerna, inklusive samtal med personal på plats, för att dokumentera utformning av och brister på stationerna.Analys av data över antal obehöriga spårbeträdanden och påkörningar vid dessa stationer samt förseningar som en följd av dessa händelser.Analys av händelser som inkommit till Trygghetscentralen gällande de tre stationerna.Resenärsenkät kring upplevd trygghet, säkerhet samt information på de tre pendeltågsstationerna.Rekrytering skedde genom anslag på berörda stationer, annons på Facebook samt på Instagram.Personalenkät (med liknande innehåll som i resenärsenkäten) riktad till lokalvårdare, ordningsvakter och stationsvärdar (spärrvakter).Intervjuer med pendeltågsförare, stationschefer och entreprenörer.Omkring 90% av de deltagande resenärerna svarade att de visste att det är olagligt att befinna sig i spårområdet redan innan de deltog i studien. I Årstaberg upplevde resenärerna att stationen var mindre säker (med tanke på risken att ramla ner på spåret) än vad man gjorde i Järna. I övrigt var ingen skillnad i upplevd säkerhet mellan stationerna. När det gäller hur trygga stationerna upplevdes av resenärerna (med avseende på risken för rån och överfall) var det ingen skillnad mellan stationerna på dagtid. På kvällar/nätter upplevdes dock Upplands Väsby som mer otrygg än Årstaberg.
|
|
