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17-year trends in incidence and prognosis of cardiogenic shock in patients with acute myocardial infarction in western Sweden.

https://arctichealth.org/en/permalink/ahliterature269417
Source
Int J Cardiol. 2015 Apr 15;185:256-62
Publication Type
Article
Date
Apr-15-2015
Author
B. Redfors
O. Angerås
T. Råmunddal
C. Dworeck
I. Haraldsson
D. Ioanes
P. Petursson
B. Libungan
J. Odenstedt
J. Stewart
E. Lodin
M. Wahlin
P. Albertsson
G. Matejka
E. Omerovic
Source
Int J Cardiol. 2015 Apr 15;185:256-62
Date
Apr-15-2015
Language
English
Publication Type
Article
Keywords
Aged
Electrocardiography
Female
Forecasting
Humans
Incidence
Male
Myocardial Infarction - complications - epidemiology
Retrospective Studies
Risk factors
Shock, Cardiogenic - epidemiology - etiology
Sweden - epidemiology
Abstract
Cardiogenic shock remains the leading cause of in hospital death in acute myocardial infarction (AMI) and is associated with a mortality rate of approximately 50%. Here we investigated the 17-year trends in incidence and prognosis of AMI-induced cardiogenic shock in Västra Götaland in western Sweden, an area with approximately 1.6 million inhabitants. The study period includes the transition from thrombolysis to primary percutaneous coronary intervention (PCI) as the region-wide therapy of choice for patients with ST-elevation myocardial infarction (STEMI).
Data on patients hospitalized in cardiac care units in Västra Götaland, Sweden between 1995 and 2013 were obtained from the Swedish Websystem for Enhancement of Evidence-based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART). We determined the incidence of cardiogenic shock among patients diagnosed with AMI and the risk of death associated with developing cardiogenic shock. We fitted logistic regression models to study which factors predicted post-AMI cardiogenic shock. Analyses were performed on complete case data as well as after multiple imputation of missing data.
Incidence of cardiogenic shock as a complication of AMI declined in western Sweden in the past decade, from 14% in 1995 to 4% in 2012. The risk of dying once cardiogenic shock had developed increased during the study period (p
PubMed ID
25814213 View in PubMed
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Angiographic findings and survival in patients undergoing coronary angiography due to sudden cardiac arrest in western Sweden.

https://arctichealth.org/en/permalink/ahliterature269292
Source
Resuscitation. 2015 May;90:13-20
Publication Type
Article
Date
May-2015
Author
Björn Redfors
Truls Råmunddal
Oskar Angerås
Christian Dworeck
Inger Haraldsson
Dan Ioanes
P. Petursson
Berglind Libungan
Jacob Odenstedt
Jason Stewart
Lotta Robertsson
Magnus Wahlin
Per Albertsson
Johan Herlitz
Elmir Omerovic
Source
Resuscitation. 2015 May;90:13-20
Date
May-2015
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - mortality - radiography - therapy
Aged
Coronary Angiography
Coronary Artery Disease - mortality - radiography - therapy
Coronary Occlusion - mortality - radiography - therapy
Female
Heart Arrest - mortality
Humans
Logistic Models
Male
Percutaneous Coronary Intervention
Propensity Score
Proportional Hazards Models
Prospective Studies
Registries
Severity of Illness Index
Sweden - epidemiology
Abstract
Sudden cardiac arrest (SCA) accounts for more than half of all deaths from coronary heart disease. Time to return of spontaneous circulation is the most important determinant of outcome but successful resuscitation also requires percutaneous coronary intervention in selected patients. However, proper selection of patients is difficult. We describe data on angiographic finding and survival from a prospectively followed SCA patient cohort.
We merged the RIKS-HIA registry (Register of Information and Knowledge about Swedish Heart Intensive Care Admissions) and SCAAR (Swedish Coronary Angiography and Angioplasty Registry) for patients hospitalized in cardiac care units in Western Sweden between January 2005 and March 2013. We performed propensity score-adjusted logistic and Cox proportional-hazards regression analyses on complete-case data as well as on imputed data sets.
638 consecutive patients underwent coronary angiography due to SCA. Severity of coronary artery disease was similar among SCA patients and patients undergoing coronary angiography due to suspected coronary artery disease (n=37,142). An acute occlusion was reported in the majority of SCA patients and was present in 37% of patients who did not have ST-elevation on the post resuscitation ECG. 31% of SCA patients died within 30 days. Long-term risk of death among patients who survived the first 30 days was higher in patients with SCA compared to patients with acute coronary syndromes (P
PubMed ID
25698668 View in PubMed
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Long-term mortality in patients with type 2 diabetes undergoing coronary angiography: the impact of glucose-lowering treatment.

https://arctichealth.org/en/permalink/ahliterature124602
Source
Diabetologia. 2012 Aug;55(8):2109-17
Publication Type
Article
Date
Aug-2012
Author
N. Saleh
P. Petursson
B. Lagerqvist
H. Skúladóttir
A. Svensson
B. Eliasson
S. Gudbjörnsdottir
K. Eeg-Olofsson
A. Norhammar
Author Affiliation
Cardiology Unit, Department of Medicine, Karolinska University Hospital, N3:06, Solna, 171 76, Stockholm, Sweden.
Source
Diabetologia. 2012 Aug;55(8):2109-17
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Aged
Comorbidity
Coronary Angiography - mortality - statistics & numerical data
Coronary Disease - etiology - mortality - therapy
Diabetes Mellitus, Type 2 - complications - mortality - therapy
Diabetic Angiopathies - etiology - mortality - therapy
Diet Therapy - statistics & numerical data
Female
Follow-Up Studies
Humans
Hypoglycemic Agents - adverse effects - therapeutic use
Insulin - adverse effects - therapeutic use
Male
Retrospective Studies
Survival Analysis
Sweden - epidemiology
Time Factors
Abstract
The aim of this study was to analyse whether the increased mortality rates observed in insulin-treated patients with type 2 diabetes and coronary artery disease are explained by comorbidities and complications.
A retrospective analysis of data from two Swedish registries of type 2 diabetic patients (n = 12,515) undergoing coronary angiography between the years 2001 and 2009 was conducted. The association between glucose-lowering treatment and long-term mortality was studied after extensive adjustment for cardiovascular- and diabetes-related confounders. Patients were classified into four groups, according to glucose-lowering treatment: diet alone; oral therapy alone; insulin in combination with oral therapy; and insulin alone.
After a mean follow-up time of 4.14 years, absolute mortality rates for patients treated with diet alone, oral therapy alone, insulin in combination with oral therapy and insulin alone were 19.2%, 17.4%, 22.9% and 28.1%, respectively. Compared with diet alone, insulin in combination with oral therapy (HR 1.27; 95% CI 1.12, 1.43) and insulin alone (HR 1.62; 95% CI 1.44, 1.83) were associated with higher mortality rates. After adjustment for baseline differences, insulin in combination with oral glucose-lowering treatment (HR 1.22; 95% CI 1.06, 1.40; p
PubMed ID
22566103 View in PubMed
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[Physicians faced with reporting in campaign against doping]

https://arctichealth.org/en/permalink/ahliterature75139
Source
Nord Med. 1993;108(6-7):182-3
Publication Type
Article
Date
1993
Author
P. Pétursson
Source
Nord Med. 1993;108(6-7):182-3
Date
1993
Language
Swedish
Publication Type
Article
Keywords
Adolescent
Adult
Confidentiality
Doping in Sports - legislation & jurisprudence
English Abstract
Humans
Iceland
Male
Mass Media
Physician-Patient Relations
Public Relations
Abstract
Despite its geographic isolation Iceland has not escaped the advent of problems with illicit drug-taking and abuse of hormones and other agents, in athletics and in other contexts. Denial of abuse, both by individuals and by athletics clubs, is facilitated by the secrecy surrounding usage and a certain insouciance among physicians with regard to the occurrence of abuse and the health risks involved, paired with a tendency to put confidentiality before the obligation to report incipient signs of health hazards and epidemiological trends. Good relations with the mass media, open factual discussions, and the civil courage to sound the alarm as early as possible, will be needed if such health risks to the community are to be discovered and counteracted.
PubMed ID
8321642 View in PubMed
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What determines a family doctor's prescribing habits for antibiotics? A comparative study on a doctor's own behaviour in two different settings.

https://arctichealth.org/en/permalink/ahliterature210519
Source
Scand J Prim Health Care. 1996 Dec;14(4):196-202
Publication Type
Article
Date
Dec-1996
Author
P. Pétursson
Author Affiliation
Akureyri Primary Health Care Centre, Iceland.
Source
Scand J Prim Health Care. 1996 Dec;14(4):196-202
Date
Dec-1996
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - therapeutic use
Drug Prescriptions
Drug Utilization - statistics & numerical data
Family Practice - statistics & numerical data
Group Practice
Humans
Iceland
Morbidity
Physician's Practice Patterns - statistics & numerical data
Private Practice
Retrospective Studies
Rural Health
Urban health
Abstract
To compare the author's prescribing habits for antibiotics in two different work settings and to study the reasons for the observed different trends.
A retrospective database study of computer-based patient records. The author's 55,261 patient contacts during a nine-year period were investigated.
A solo practice in a small isolated fishing village, Bolungarvík, in 1984-1987, and a group practice in the town of Akureyri in 1987-1992, where the people had a free choice of doctors.
The author himself was the subject of the study.
Type and number of prescriptions of antibiotics. The predictive variables were number and type of contacts, number of listed patients, age and sex of the patients, diagnosis, and the use of laboratory investigations.
From 1984 to 1986 the author reduced the number of his prescriptions of antibiotics from 82.9 to 63.8 per 1000 contacts (p
PubMed ID
8956446 View in PubMed
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