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71.
Lindholm MG Aldershvile J Sundgreen C Jørgensen E Saunamäki K Boesgaard S 《European journal of heart failure》2003,5(1):73-79
BACKGROUND: Five to 10% of patients with acute myocardial infarction develop cardiogenic shock and the majority of these patients are expected to die within the first few weeks. In this study, we review our recent experience in the management of patients with cardiogenic shock complicating MI and examine the effect of early invasive revascularisation on mortality. METHODS: Thirty-six consecutive patients who developed cardiogenic shock less than 48 h after MI were retrospectively evaluated and divided into two treatment groups. One group received early invasive revascularisation (n=24) and the other group had no early invasive revascularisation, but received similar conventional intensive care medical treatment (n=12). RESULTS: Baseline characteristics and hemodynamic variables were similar in both groups. Apart from invasive revascularisation and the use of intra aortic balloon counterpulsation (IABP), treatment strategies did not differ between the two groups. Thirty-day mortality was 21% in the revascularised group of patients and 58% in the non-revascularised group (P<0.05). CONCLUSIONS: Our data support previous observations suggesting that an aggressive treatment strategy including early invasive revascularisation and IABP is associated with improved short and long-term survival in patients with cardiogenic shock. Since early revascularisation appears safe with a considerable treatment benefit, this approach must be considered in patients with short shock duration early after MI. 相似文献
72.
Pia Cecilie Bing-Jonsson RN MSc PhD Linn Hege Førsund RN MSc PhD Jarle Hansen Stålesen MSc Birgitte Vabo Nesland RN Ina Cecilie Lindholm RN Olga Rugsland Espegren Physio MBA 《Scandinavian journal of caring sciences》2023,37(4):1057-1066
Aims and Objectives
This study reports from a municipality in Norway that implemented a competence enhancement programme for all its institutional nursing staff during the COVID-19 pandemic to fill identified competence gaps.Background
Many Norwegian municipalities are experiencing a demand for expanded community healthcare services due to an increase in elderly patients and patients with extensive and complex needs. At the same time, most municipalities are striving to recruit and keep competent health personnel. New ways of organising and increasing the competence of the workforce may help ensure that the healthcare delivered corresponds to patients' changing needs.Design and Methods
Nursing staff were encouraged to complete targeted competence enhancing activities with the aim of enhancing their competence in identified areas. The learning activities were blended and consisted of e-learning courses, lectures, supervision, vocational training and meetings with a superior. Competence was measured before and after the competence enhancing activities (n = 96). The STROBE checklist was applied.Results
The results provide insight into the competence development of registered nurses and assistant nurses in institutional community health services. They show that the implementation of a workplace-based blended learning programme improved competence significantly, especially for assistant nurses.Conclusions
Offering workplace-based competence enhancing activities seems to be a sustainable way of facilitating lifelong learning among nursing staff. Facilitation of learning activities in a blended learning space may enhance accessibility and increase the potential for participation. A combination of reorganisation of roles and simultaneous competence enhancing activities can ensure that both managers and nursing staff prioritise filling competence gaps. 相似文献73.
Katrine Lindholm Bøgh Mie Scharff Andreasen Charlotte Bernhard Madsen 《Scandinavian journal of immunology》2020,92(1):e12891
There is a need for efficient methods to treat food allergy; however, no immunotherapeutic method has yet been satisfactory due to the high rate of unpredictable severe reactions and the limited efficacy. Therefore, modified versions of food allergens have been suggested as alternatives to the parent proteins for immunotherapy. The aim of the study was to compare the inherent allergenicity of the native and denatured version of the cow's milk proteins β-lactoglobulin and α-lactalbumin, and to study the impact of the use of Al(OH)3 as an adjuvant. Brown Norway rats were immunized intraperitoneally with either native or denatured β-lactoglobulin or α-lactalbumin, with or without the use of Al(OH)3 as adjuvant. Antibody responses were analysed in various ways by means of different ELISAs. Both the immunogenicity and the sensitizing capacity of the cow's milk allergens were influenced by their globular folding, with the native version being more allergenic than the denatured counterpart. The native folded proteins mainly raised antibodies against conformational epitope, whereas the denatured versions predominantly raised antibodies against linear epitopes. Most interestingly, the study showed that the use of Al(OH)3, besides increasing immunogenicity and sensitizing capacity of the cow's milk allergens, caused a modification of the specificity of the antibodies raised against the native version of the proteins. Adsorption of the native forms of the allergens to Al(OH)3 caused a significant greater proportion of antibodies raised against linear epitopes, stressing that the adsorption induced a partly unfolding of the proteins. This may have implications for IT safety and efficacy. 相似文献
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77.
Martin Janson Gunnar Edlund Ulf Kressner Elisabet Lindholm Lars Påhlman Stefan Skullman Bo Anderberg Eva Haglind 《Surgical endoscopy》2009,23(8):1764-1769
Objective The colon cancer laparoscopic or open resection (COLOR) trial is an international, randomised controlled trial comparing outcomes
of open and laparoscopic surgery for colon cancer. The main purpose of this study was to determine representability by comparing
included and nonincluded patients in the participating Swedish centres.
Design At eight centres, which included 391 of the 422 Swedish patients, a local database search was performed to identify retrospectively
all patients (n = 2,384) who underwent surgery for colon cancer during the inclusion period, and data was retrieved from medical records.
Results Four hundred fifty-six patients were randomised, 65 of whom were excluded post randomisation (group 2), leaving 391 patients
in the study (group 1). For 1,566 patients, valid exclusion criteria were found (group 3). Thus, 362 patients were eligible
but not included (group 4). Relative to group 1, patients in group 4 had a significantly higher American Society of Anaesthesiologists
(ASA) score, more advanced tumour stage and difference regarding the resections performed. Results showed that 1470 patients
(62%) could be calculated as feasible for laparoscopic colon resection (LCR) in a clinical, nontrial situation.
Conclusions The study population in the Swedish part of the COLOR trial was representative of the eligible population with the exception
of comorbidity, where those actually included had less severe comorbidity than the nonincluded but eligible patients. In Sweden,
50–60% of colon cancer patients can be operated on by laparoscopy.
This work was supported by grants from the Swedish Cancer Society (Project Number 4287-B01-03XCC and Project Number 1921-B03-21XCC),
the County Council of Stockholm, Assar Gabrielsson’s Foundation for Clinical Research, Jubileumskliniken Research Foundation,
Sahlgrenska University Hospital and the Swedish Society of Medicine.
A preliminary version of this paper was previously published in an academic thesis; “Laparoscopic and open surgery for colon
cancer. Studies on costs and health related quality of life” by Martin Janson, Karolinska Institutet 2006, ISBN 91-7140-782-0. 相似文献
78.
Armin Spreco Anna Jud Olle Eriksson Kristian Soltesz Reidar Kllstrm
rjan Dahlstrm Henrik Eriksson Joakim Ekberg Carl-Oscar Jonson Carl-Johan Fraenkel Torbjrn Lundh Philip Gerlee Fredrik Gustafsson Toomas Timpka 《Emerging infectious diseases》2022,28(3):564
We report on local nowcasting (short-term forecasting) of coronavirus disease (COVID-19) hospitalizations based on syndromic (symptom) data recorded in regular healthcare routines in Östergötland County (population ≈465,000), Sweden, early in the pandemic, when broad laboratory testing was unavailable. Daily nowcasts were supplied to the local healthcare management based on analyses of the time lag between telenursing calls with the chief complaints (cough by adult or fever by adult) and COVID-19 hospitalization. The complaint cough by adult showed satisfactory performance (Pearson correlation coefficient r>0.80; mean absolute percentage error <20%) in nowcasting the incidence of daily COVID-19 hospitalizations 14 days in advance until the incidence decreased to <1.5/100,000 population, whereas the corresponding performance for fever by adult was unsatisfactory. Our results support local nowcasting of hospitalizations on the basis of symptom data recorded in routine healthcare during the initial stage of a pandemic. 相似文献
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80.
Two consecutive pregnancies in a woman with initially undiagnosed type I distal arthrogryposis (DA) are reported. A prenatal diagnosis of the condition was made by ultrasound in the 17th week of gestation in one of the pregnancies, whereas in the subsequent pregnancy the disorder was excluded as early as 13 weeks' gestation. The diagnoses were verified at birth. The feasibility of prenatal diagnosis of DA type I in the second trimester is thus confirmed and its possibility in the late first trimester is suggested. 相似文献