The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Gaea Norvegica /

v. 1 (1838

Challenges for the construction of historical price indices : the case of Norway, 1777-1920

This paper reviews some methodological and practical problems encountered in the construction of historical price indices. The underlying data sets in such studies are often characterized by heterogenous and incomplete price series. It is shown that by using the repeat sales method for constructing the subindices for individual commodity groups some of the main problems can be overcome. The procedures are illustrated by material from the construction of monthly price indices for Norway from the year 1777 to 1920. The price indices shed new light on two great wartime in ationary episodes in Norway: 1807-1817 and 1913-1920. In spite of a 61-fold increase in the price level in the rst period and a 4-fold increase in the second, it is found that, after in ation had been brought under control, prices reverted to a level consistent with the purchasing power parity principle

Twenty of the most thermophilous vascular plant species in Svalbard and their conservation state

An aim for conservation in Norway is preserving the Svalbard archipelago as one of the least disturbed areas in the Arctic. Information on local distribution, population sizes and ecology is summarized for 20 thermophilous vascular plant species. The need for conservation of northern, marginal populations in Svalbard is reviewed, using World Conservation Union categories and criteria at a regional scale. Thirteen species reach their northernmost distribution in Svalbard, the remaining seven in the western Arctic. Nine species have 1-8 populations in Svalbard and are assigned to Red List categories endangered or critically endangered: Campanula rotundifolia, Euphrasia frigida, Juncus castaneus, Kobresia simpliciuscula, Rubus chamaemorus, Alchemilla glomerulans, Ranunculus wilanderi, Salix lanata and Vaccinium uliginosum, the last four species needing immediate protective measures. Five species are classified as vulnerable: Betula nana, Carex marina ssp. pseudolagopina, Luzula wahlenbergii, Ranunculus arcticus and Ranunculus pallasii. Six species are considered at lower risk: Calamagrostis stricta, Empetrum nigrum ssp. hermaphroditum, Hippuris vulgaris (only occurring on Bjørnøya), Juncus triglumis, Ranunculus lapponicus and Rhodiola rosea. The warmer Inner Arctic Fjord Zone of Spitsbergen supports most of the 20 target species and is of particular importance for conservation. Endangered or vulnerable species were found in a variety of edaphic conditions; thus, several kinds of habitats need protection

The management of acute venous thromboembolism in clinical practice - study rationale and protocol of the European PREFER in VTE Registry

Background: Venous thromboembolism (VTE) is a major health problem, with over one million events every year in Europe. However, there is a paucity of data on the current management in real life, including factors influencing treatment pathways, patient satisfaction, quality of life (QoL), and utilization of health care resources and the corresponding costs. The PREFER in VTE registry has been designed to address this and to understand medical care and needs as well as potential gaps for improvement. Methods/design: The PREFER in VTE registry was a prospective, observational, multicenter study conducted in seven European countries including Austria, France Germany, Italy, Spain, Switzerland, and the UK to assess the characteristics and the management of patients with VTE, the use of health care resources, and to provide data to estimate the costs for 12 months treatment following a first-time and/or recurrent VTE diagnosed in hospitals or specialized or primary care centers. In addition, existing anticoagulant treatment patterns, patient pathways, clinical outcomes, treatment satisfaction, and health related QoL were documented. The centers were chosen to reflect the care environment in which patients with VTE are managed in each of the participating countries. Patients were eligible to be enrolled into the registry if they were at least 18 years old, had a symptomatic, objectively confirmed first time or recurrent acute VTE defined as either distal or proximal deep vein thrombosis, pulmonary embolism or both. After the baseline visit at the time of the acute VTE event, further follow-up documentations occurred at 1, 3, 6 and 12 months. Follow-up data was collected by either routinely scheduled visits or by telephone calls. Results: Overall, 381 centers participated, which enrolled 3,545 patients during an observational period of 1 year. Conclusion: The PREFER in VTE registry will provide valuable insights into the characteristics of patients with VTE and their acute and mid-term management, as well as into drug utilization and the use of health care resources in acute first-time and/or recurrent VTE across Europe in clinical practice. Trial registration: Registered in DRKS register, ID number: DRKS0000479