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Andreas Birgegård Caroline Björck David Clinton 《European eating disorders review》2010,18(4):251-259
Computer‐based quality assurance of specialist eating disorder (ED) care is a possible way of meeting demands for evaluating the real‐life effectiveness of treatment, in a large‐scale, cost‐effective and highly structured way. The Internet‐based Stepwise system combines clinical utility for patients and practitioners, and provides research‐quality naturalistic data. Stepwise was designed to capture relevant variables concerning EDs and general psychiatric status, and the database can be used for both clinical and research purposes. The system comprises semi‐structured diagnostic interviews, clinical ratings and self‐ratings, automated follow‐up schedules, as well as administrative functions to facilitate registration compliance. As of June 2009, the system is in use at 20 treatment units and comprises 2776 patients. Diagnostic distribution (including subcategories of eating disorder not otherwise specified) and clinical characteristics are presented, as well as data on registration compliance. Obstacles and keys to successful implementation of the Stepwise system are discussed, including possible gains and on‐going challenges inherent in large‐scale, Internet‐based quality assurance. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association. 相似文献
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Background and objectives Iron depletion is common in regular blood donors. The objective of the study was to investigate the frequency and severity of iron depletion in regular blood donors and whether IV iron is more effective than oral to avoid iron depletion and symptoms thereof, especially restless legs syndrome (RLS). Method One hundred and twenty blood donors with at least five previous whole blood donations were randomized to receive either IV iron sucrose (Venofer®, RenaPharma/Vifor, Uppsala, Sweden), 200 mg, or to 20 × 100 mg of oral iron sulphate (Duroferon®, GlaxoSmithKline, Stockholm, Sweden), after each blood donation during 1 year. Iron status and RLS incidence and severity were investigated. Results Iron status was generally poor among regular blood donors, especially in women, with a high incidence of iron depletion (> 20%) and RLS (18%). The IV iron group increased storage iron to a greater extent than the oral iron group after 12 months (P = 0·0043). Female donors were more responsive to IV iron sucrose compared to oral iron sulphate, particularly female donors below 50 years of age. RLS severity scores were significantly lower in the IV iron group. The two treatments were safe. Conclusion Iron status is poor in regular blood donors, restless legs syndrome is common, and the routine iron supplementation is insufficient. IV iron sucrose substitutes iron loss in blood donors more efficiently compared with oral iron sulphate, especially in women. Iron substitution to blood donors should be individualized and based on P‐ferritin monitoring. 相似文献
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Transfusion of autologous blood (blood doping) has been used by athletes to improve performance in sports events. This practice has been banned by the International Ski Federation (FIS) and the International Olympic Committee (IOC). So far, no reliable method for detection of blood doping has been available. In the present study, a group of six elite cross-country skiers, who were phlebotomized and retransfused with 1350 ml of blood 4 weeks later, was compared with a control group (n = 7) in whom no blood doping was performed. The blood was stored at +4 degrees C for 4 weeks. Hemoglobin increased by 7.9% from the prephlebotomy level and by 14% from the preinfusion level. The reinfusion of blood caused a 60% reduction (P less than 0.001) in serum erythropoietin in 24 h and a sharp increase (P less than 0.05) in serum iron and bilirubin after a test race performed on the day of reinfusion. It is therefore concluded that a combination of measurements of hemoglobin and bilirubin, iron, and erythropoietin in serum could detect 50% of the blood-doped athletes by a single test sample during the 1st week after reinfusion. If two test samples were used, an increase in Hb of more than 5%, and a decrease in serum erythropoietin by more than 50%, would be discussed in 50% of the blood-doped athletes throughout the first 2 weeks after reinfusion and without implicating any of the controls. 相似文献
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Merup M Lazarevic V Nahi H Andreasson B Malm C Nilsson L Brune M LeBlanc K Kutti J Birgegård G;Swedish Group for Myeloproliferative Disorders 《British journal of haematology》2006,135(3):367-373
Allogeneic haematopoietic stem cell transplantation remains the only curative treatment of myelofibrosis with myeloid metaplasia (MMM). Previous reports have indicated significant treatment-related mortality (TRM) for patients transplanted after myeloablative conditioning but superior survival has been reported after reduced-intensity conditioning (RIC). We report the results of a survey of all allogeneic transplantations for MMM performed in Sweden at six transplant units between 1982 and 2004. Twenty-seven patients were transplanted; 17 with a myeloablative conditioning regimen and 10 with RIC. The median age was 50 years (5-63 years) at transplantation. After a median follow up of 55 months, 20 patients are alive. TRM was 10% in the RIC group and 30% in the myeloablative group. There was no difference in survival for high or low-risk patients according to Cervantes score or between sibling and unrelated donor transplantations. 相似文献
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Ludwig H Van Belle S Barrett-Lee P Birgegård G Bokemeyer C Gascón P Kosmidis P Krzakowski M Nortier J Olmi P Schneider M Schrijvers D 《European journal of cancer (Oxford, England : 1990)》2004,40(15):2293-2306
The European Cancer Anaemia Survey (ECAS) was conducted to prospectively evaluate the prevalence, incidence and treatment of anaemia (haemoglobin <12.0 g/dL) in European cancer patients, including the relationship of mild, moderate and severe anaemia to performance status. Patients were evaluated for up to 6 months. Data (N=15367) included demographics, tumour type, performance status, haemoglobin levels, cancer treatments and anaemia treatments. Prevalence of anaemia at enrollment was 39.3% (haemoglobin <10.0 g/dL, 10%), and 67.0% during the survey (haemoglobin <10.0 g/dL, 39.3%). Low haemoglobin levels correlated significantly with poor performance status. Incidence of anaemia was 53.7% (haemoglobin <10.0 g/dL, 15.2%). Anaemia was treated in 38.9% of patients (epoetin, 17.4%; transfusion, 14.9%; and iron, 6.5%). Mean haemoglobin to initiate anaemia treatment was 9.7 g/dL. Anaemia prevalence and incidence in cancer patients are high. Anaemia significantly correlates with poor performance status and many anaemic patients are not treated. 相似文献
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