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Atrial vs. dual-chamber cardiac pacing in sinus node disease: a register-based cohort study.

https://arctichealth.org/en/permalink/ahliterature93198
Source
Europace. 2008 Jul;10(7):825-31
Publication Type
Article
Date
Jul-2008
Author
Fored C Michael
Granath Fredrik
Gadler Fredrik
Blomqvist Paul
Rynder Jenny
Linde Cecilia
Ekbom Anders
Rosenqvist Mårten
Author Affiliation
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet and Karolinska University Hospital, Site Solna M9:01, SE-171 76 Stockholm, Sweden. Michael.Fored@ki.se
Source
Europace. 2008 Jul;10(7):825-31
Date
Jul-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Arrhythmia, Sinus - mortality - physiopathology - therapy
Atrial Fibrillation - epidemiology - physiopathology
Atrial Flutter - epidemiology - physiopathology
Atrioventricular Node - physiopathology
Cardiac Pacing, Artificial - adverse effects - methods
Cohort Studies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pacemaker, Artificial
Registries
Risk factors
Sinoatrial Node - physiopathology
Sweden
Treatment Outcome
Abstract
AIMS: In patients with sinus node disease, dual-chamber pacing (DDD) possibly results in adverse effects on the ventricular function. We have compared the incidence of cardiovascular morbidity and mortality in patients with sinus node disease and with atrioventricular (AV) synchronous pacemakers, DDD vs. atrial pacing (AAI). METHODS AND RESULTS: A nation-wide population-based cohort of 8777 patients with AAI- or DDD-mode pacemakers was followed during 12 years. The cohort was linked to national healthcare and census registers. Patients with DDD pacing and without any pre-implant admission for atrial fibrillation or flutter had an increased risk of post-implant fibrillation or flutter, in relation to corresponding AAA patients [hazard ratio (HR) = 1.30; 95% confidence interval (CI) 1.10-1.52]. A slight increase in the risk of any cardiovascular disease (HR = 1.07; CI, 1.00-1.15), and all-cause mortality (HR = 1.12; CI, 1.00-1.25), was seen among DDD patients, in relation to AAI patients, but there was no significant difference in the risk of ischaemic or unspecified stroke (HR = 1.14; CI, 0.94-1.37). Among DDD patients, the all-cause mortality did not differ from the general population [standardized mortality ratio (SMR) = 1.04; CI, 0.98-1.11]. Patients with AAI, however, had a decreased all-cause mortality risk (SMR = 0.89; CI, 0.82-0.97). CONCLUSION: Our results support AAI as the preferred mode of pacing in patients with sinus node disease, and a normal AV node function.
PubMed ID
18467299 View in PubMed
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Characteristics of non-urgent patients. Cross-sectional study of emergency department and primary care patients.

https://arctichealth.org/en/permalink/ahliterature92814
Source
Scand J Prim Health Care. 2008;26(3):181-7
Publication Type
Article
Date
2008
Author
Backman Ann-Sofie
Blomqvist Paul
Lagerlund Magdalena
Carlsson-Holm Eva
Adami Johanna
Author Affiliation
Department of Emergency Medicine, Stockholm Söder Hospital, Stockholm, Sweden. Ann-Sofie.Backman@ki.se
Source
Scand J Prim Health Care. 2008;26(3):181-7
Date
2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude to Health
Community Health Centers - utilization
Cross-Sectional Studies
Emergency Medical Services - utilization
Emergency Service, Hospital - utilization
Family Practice
Female
Health Services Misuse
Humans
Male
Middle Aged
Patient Acceptance of Health Care
Patients - classification - psychology
Primary Health Care - utilization
Questionnaires
Socioeconomic Factors
Sweden
Triage
Abstract
OBJECTIVE: To describe characteristics of patients seeking medical attention for non-urgent conditions at an emergency department (ED) and patients who use non-scheduled services in primary healthcare. DESIGN: Descriptive cross-sectional study. SETTING: Primary healthcare centres and an ED with the same catchment area in Stockholm, Sweden. PATIENTS: Non-scheduled primary care patients and non-referred non-urgent ED patients within a defined catchment area investigated by structured face-to-face interviews in office hours during a nine-week period. MAIN OUTCOME MEASURES: Sociodemographic characteristics, chief complaints, previous healthcare use, perception of symptoms, and duration of symptoms before seeking care. RESULTS: Of 924 eligible patients, 736 (80%) agreed to participate, 194 at the ED and 542 at nine corresponding primary care centres. The two groups shared demographic characteristics except gender. A majority (47%) of the patients at the primary care centres had respiratory symptoms, whereas most ED patients (52%) had digestive, musculoskeletal, or traumatic symptoms. Compared with primary care patients, a higher proportion (35%) of the ED patients had been hospitalized previously. ED patients were also more anxious about and disturbed by their symptoms and had had a shorter duration of symptoms. Both groups had previously used healthcare frequently. CONCLUSIONS: Symptoms, previous hospitalization and current perception of symptoms seemed to be the main factors discriminating between patients studied at the different sites. There were no substantial sociodemographic differences between the primary care centre patients and the ED patients.
PubMed ID
18609257 View in PubMed
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Encephalitis after influenza in Sweden 1987-1998: a rare complication of a common infection.

https://arctichealth.org/en/permalink/ahliterature89622
Source
Eur Neurol. 2009;61(5):289-94
Publication Type
Article
Date
2009
Author
Hjalmarsson Anders
Blomqvist Paul
Brytting Maria
Linde Annika
Sköldenberg Birgit
Author Affiliation
Infectious Diseases Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. anders.hjalmarsson@ki.se
Source
Eur Neurol. 2009;61(5):289-94
Date
2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Encephalitis, Viral - epidemiology - etiology - mortality
Female
Humans
Incidence
Influenza, Human - complications - epidemiology - mortality
Male
Middle Aged
Registries
Sweden - epidemiology
Young Adult
Abstract
The aim of this study was to investigate the incidence of influenza-related encephalitis in Sweden during 11.5 years. Studies from Japan report an increased incidence of influenza-related encephalitis/encephalopathy. Few other studies are available. We conducted a retrospective register-based study on the Swedish National Inpatient Register, which covers all Swedish hospitals. In 1987-1998, a total number of 14,250 hospitalized individuals had an influenza diagnosis (population incidence: 137 per million person-years). In-hospital mortality was 4.1%. Using three different approaches, only 21 cases of influenza-related encephalitis were found, corresponding to a rate of 1.5 per 1,000 hospitalized persons with an influenza diagnosis (population incidence 0.21 per million person-years). We conclude that encephalitis following influenza occurs rarely, or is an infrequently recognized, diagnosed or reported complication. The cases we studied in detail have all recovered without sequels.
PubMed ID
19295216 View in PubMed
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Herpes simplex encephalitis in Sweden, 1990-2001: incidence, morbidity, and mortality.

https://arctichealth.org/en/permalink/ahliterature83492
Source
Clin Infect Dis. 2007 Oct 1;45(7):875-80
Publication Type
Article
Date
Oct-1-2007
Author
Hjalmarsson Anders
Blomqvist Paul
Sköldenberg Birgit
Author Affiliation
Infectious Diseases Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. anders.hjalmarsson@ki.se
Source
Clin Infect Dis. 2007 Oct 1;45(7):875-80
Date
Oct-1-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Encephalitis, Herpes Simplex - complications - mortality
Humans
Incidence
Infant
Infant, Newborn
Middle Aged
Morbidity
Recurrence
Registries
Retrospective Studies
Simplexvirus - pathogenicity
Sweden - epidemiology
Abstract
BACKGROUND: Herpes simplex encephalitis (HSE) is a devastating disease. METHODS: In Sweden, a nationwide retrospective study of the incidence, morbidity, and mortality associated with HSE during the 12-year period 1990-2001 was conducted. The national inpatient register data were used, and diagnostic data from the virus laboratories were validated. RESULTS: In the study period, 638 patients hospitalized in Sweden received a primary diagnosis of HSE. Of these, 236 patients had a confirmed infection of the central nervous system due to herpes simplex virus type 1. This corresponds to an incidence of confirmed HSE due to herpes simplex virus type 1 of 2.2 cases per million population per year. Of the survivors, 87% were readmitted to the hospital. The most frequent diagnosis at readmission was epilepsy, which was found in 49 patients (21% of the 236 total patients; 24% of 203 survivors), with a median onset 9.3 months after the diagnosis of HSE. This corresponds to a 60- to 90-fold increase in risk, compared with that for the general population. Neuropsychiatric sequelae were evident in 45 (22%) of 203 surviving patients. The incidence of venous thromboembolism, including pulmonary embolism, was 5-14 times higher than that in the general population. Among patients with HSE due to herpes simplex virus type 1, the 1-year mortality was 14% (33 of 236 patients died), which was 8 times higher than expected. CONCLUSIONS: This is, to our knowledge, the first study to report long-term, nationwide follow-up data for patients with virologically confirmed HSE. There is considerable morbidity after HSE, with epilepsy being the most common diagnosis. This demonstrates the need for expanding our knowledge of the pathogenesis of HSE to direct more effective antiviral and antiinflammatory treatments.
Notes
Comment In: Clin Infect Dis. 2007 Oct 1;45(7):881-217806054
PubMed ID
17806053 View in PubMed
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Surgical treatment of hallux valgus and forefoot deformities in Sweden: a population-based study.

https://arctichealth.org/en/permalink/ahliterature85906
Source
Foot Ankle Int. 2008 Mar;29(3):298-304
Publication Type
Article
Date
Mar-2008
Author
Saro Carlos
Bengtsson Ann-Sophie
Lindgren Urban
Adami Johanna
Blomqvist Paul
Felländer-Tsai Li
Author Affiliation
Karolinska Institute at Karolinska University Hospital, CLINTEC, Division of Orthopaedics, Hälsovägen, Stockholm, 141 86, Sweden. carlos.saro@ki.se
Source
Foot Ankle Int. 2008 Mar;29(3):298-304
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Ambulatory Surgical Procedures - statistics & numerical data
Female
Hallux Valgus - diagnosis - epidemiology - surgery
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Middle Aged
Orthopedic Procedures - statistics & numerical data
Prevalence
Sex Distribution
Sweden - epidemiology
Abstract
BACKGROUND: Although surgical correction for hallux valgus and other toe deformities is one of the most common procedures in foot surgery, its incidence in the general population is not well-known. MATERIALS AND METHODS: The study population comprised patients living in Sweden of a varied age group and both sexes who underwent forefoot surgery. We identified all inpatient cases from 1997 to 2000 and all ambulatory cases in 2000 registered in the National Swedish Patient Register (NSPR). Further, clinical data for the surgical treatment of hallux valgus deformity were extracted from medical records in patients treated in a geographically defined region (Stockholm). RESULTS: In total, 6956 patients with surgically treated forefoot deformities were identified from the adult population, equivalent to a cumulative incidence of 0.8 procedures per 1000 inhabitants for the whole analyzed group. There were regional variations and significant sex differences. The age distribution in both sexes was characterized by a peak in the fifth decade. Forefoot surgery was statistically more frequently performed in private clinics than in public hospitals (p
PubMed ID
18348826 View in PubMed
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