Aktuelle Entwicklungslinien in der schwedischen Quartärgeologie

researc

Percutaneous coronary intervention in Europe 1992-2003

peer reviewedAims: The purpose of this registry is to collect data on trends in interventional cardiology within Europe. Special interest focuses on relative increases and ratios in newer revascularization approaches and its distribution in different regions in Europe. We report the data of the year 2003 and give an overview of the development of coronary interventions since 1992, when the first data collection was performed. Methods and results: Questionnaires were distributed yearly to delegates of all national societies of cardiology represented in the European Society of Cardiology to collect the case numbers of all local institutions and operators. The overall numbers of coronary angiographies increased from 1992 to 2003 from 684,000 to 1,993,000 (from 1,250 to 3,500 per million inhabitants). The respective numbers for percutaneous coronary interventions (PCI-coronary angioplasty) and coronary stenting procedures increased from 184,000 to 733,000 (from 335 to 1,300) and from 3,000 to 610,000 (from 5 to 1,100), respectively. Germany has been the most active country for the past years with 653,000 angiographies (7,800), 222,000 angioplasties (2,500), and 180,000 stenting procedures (2,200) in 2003. The indication has shifted towards acute coronary syndromes, as demonstrated by raising rates of interventions for acute myocardial infarction over the last decade. The procedures are more readily performed and safer, as shown by increasing rate of “ad hoc” PCI and decreasing need for emergency coronary artery bypass surgery (CABG). In 2003, use of drug-eluting stents had further increased. However, an enormous variability is reported with the highest rate in Portugal (55%). Conclusion: Interventional cardiology in Europe is still expanding, mainly but not exclusively due to rapid growth in the eastern European countries. A number of new coronary revascularization procedures introduced over the years have all but disappeared. Only stenting has experienced an exponential growth. The same can be forecast for drug-eluting stenting

Pollen profile from Schonen, Sweden

Two new Standard pollen diagrams from the raised bog Ageröds mosse in central Scania are presented and discussed. They have been made giving extensive consideration to the NAP and spores also. The new diagrams comprise in the main only the Post-glacial and can easily be compared with the earlier published Standard diagram from the bog (T. NILSSON 1935). The development of the Post-glacial Vegetation in the surroundings is also discussed and compared with the conditions in the southernmost part of the province (Bjärsjöholmssjön, T. Nilsson 1961). One of the new diagrams has been prepared in connection with the study of a core brought up by means of a special borer in order to bring about C14 datings. The core was almost ömlong and had a diameter of 6 cm. It was divided into pieces of 2—6 cm, which were preserved. After the preparation of the pollen diagram, suitable samples were selected for C14 dating. In all 33 samples, comprising the whole Post-glacial inclusive of the youngest part of the Late-glacial, were C14-dated. With the aid of the C14 dates the growth conditions of the bog are discussed. After very slow Sedimentation of predominantly minerogenous deposits in the last part of the Late-glacial, and still slow Sedimentation of gyttjas in the oldest part of the Post-glacial, the rate of growth (primarily of the gyttja) distinctly increased in the first part of the Late Boreal. A temporary retardation of the growth of the sphagnum peat at the end of the Sub-boreal is probably entirely local. The average rate of growth of the really highly humified parts of the old sphagnum peat amounts to 42 mm per Century, that of the slightly humified young sphagnum peat 81 mm per Century or somewhat more. Based on the C14-determinations, the pollen zone boundaries have been given the following approximate dates: boundary Late-glacial/Post-glacial (DR/PB) 8300 B.C., boundary Pre-boreal/Boreal (PB/BO) 7900 B.C., boundary Early Boreal/Late Boreal (BO 1/2) 6800 B.C., boundary Boreal/Atlantic (BO/AT) 6200 B.C., boundary Early Atlantic/Late Atlantic (AT 1/2) 4600 B.C. (?), boundary Atlantic/Sub-boreal (AT/SB) 3300 B.C., boundary Early Sub-boreal/Late Sub-boreal (SB 1/2) 1700—1800 B.C., boundary Sub-boreal/Sub-atlantic (SB/ SA) 300 B.C., boundary Early Sub-atlantic/Late Sub-atlantic (SA 1/2) 650 A.D

Pulmonary embolism : Validation of diagnostic imaging methods in the clinical setting

Pulmonary embolism (PE) is an elusive diagnosis and none of the existing imaging modalities have a 100% diagnostic specificity or sensitivity. Pulmonary arteriography (PA) is the most specific test although the improvement of computed tomography technique has made this a commonly used method. Lung scintigraphy often gives ambiguous results. Fibrin split products (D-dimer) are released into the blood in PE were elevated levels can be measured. However, D-dimer levels are elevated in venous thromboembolic (VTE) disease as well as in a number of other conditions. The aims of this thesis were to evaluate different radiological methods including pulmonary arteriography, lung scintigraphy and spiral computed tomography for the diagnosis of acute pulmonary embolism and to study if a clinical probability protocol or a simple blood test such as D- dimer could improve the diagnostic accuracy. Study I investigated the complication rate of PA in 707 patients. The overall complication rate was 1.6%, which is lower than previously reported. Study II assessed the interobserver variations in PA in 170 patients and compared the consensus results to a final outcome diagnosis. The mean interobserver agreement was 89%, higher for central vessel emboli, lower for peripheral locations. Study III investigated if the use of a combination of a clinical and scintigraphic protocol in relation to the final outcome could improve the diagnosis in patients with clinical suspicion of acute PE. A low combined probability yielded a negative predictive value (NPV) of 98%. The positive predictive value (PPV) was 100% if the combined probability was high. Study IV compared the diagnostic accuracy of contrast medium enhanced spiral computed tomography of the pulmonary arteries (s-CTPA) and a latex agglutination D-dimer assay in patients with suspected acute PE by using PA and clinical follow up as reference method. sCTPA had 95% NPV and 94% PPV. If a cut off level of 0.25 mg/L was used the corresponding figures for D-dimer were 92% and 63%. Study V investigated if 441 patients with a negative s-CTPA and without DVT symptoms, venous studies or anticoagulant treatment had a new episode of PE during three months follow up. Only 0.9% of the patients had proven PE during the follow up period. To conclude, the results of our studies show that PA is a safe method with good interobserver agreement and low complication rate. By applying a model of combined clinical and scintigraphic probabilities for PE, the diagnosis is ruled in when the combined probability is high, and ruled out when the combined probability is low. However, nearly half of the patients will still have an uncertain diagnosis if lung scintigraphy is used as diagnostic method. A low cut-off level of D-dimer can be used as a screening test to rule out PE, but can not confirm the diagnosis. s-CTPA has a high diagnostic accuracy when compared to PA. The overall results indicate that a negative s-CTPA result safely can rule out the existence of clinically significant, acute PE

The Pleistocene : geology and life in the quaternary Ice Age /

Bibliography: p. 540-620.Includes index