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The Study Protocol for the LINC (LUCAS in Cardiac Arrest) Study: a study comparing conventional adult out-of-hospital cardiopulmonary resuscitation with a concept with mechanical chest compressions and simultaneous defibrillation
Rubertsson Sten,Silfverstolpe Johan,Rehn Liselott,Nyman Thomas
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2013, DOI: 10.1186/1757-7241-21-5
Abstract: Background The LUCAS device delivers mechanical chest compressions that have been shown in experimental studies to improve perfusion pressures to the brain and heart as well as augmenting cerebral blood flow and end tidal CO2, compared with results from standard manual cardiopulmonary resuscitation (CPR). Two randomised pilot studies in out-of-hospital cardiac arrest patients have not shown improved outcome when compared with manual CPR. There remains evidence from small case series that the device can be potentially beneficial compared with manual chest compressions in specific situations. This multicentre study is designed to evaluate the efficacy and safety of mechanical chest compressions with the LUCAS device whilst allowing defibrillation during on-going CPR, and comparing the results with those of conventional resuscitation. Methods/design This article describes the design and protocol of the LINC-study which is a randomised controlled multicentre study of 2500 out-of-hospital cardiac arrest patients. The study has been registered at ClinicalTrials.gov (http://clinicaltrials.gov/ct2/show/NCT00609778?term=LINC&rank=1). Results Primary endpoint is four-hour survival after successful restoration of spontaneous circulation. The safety aspect is being evaluated by post mortem examinations in 300 patients that may reflect injuries from CPR. Conclusion This large multicentre study will contribute to the evaluation of mechanical chest compression in CPR and specifically to the efficacy and safety of the LUCAS device when used in association with defibrillation during on-going CPR.
Increased free androgen index is associated with hypertension in premenopausal women  [PDF]
Liselott Andersson, Mats Eliasson, Inger Sundstr?m Poromaa
Open Journal of Obstetrics and Gynecology (OJOG) , 2011, DOI: 10.4236/ojog.2011.14045
Abstract: Objective: Increased testosterone and decreased sex hormone-binding globulin (SHBG) are associated with a number of adverse cardiovascular risk factors in postmenopausal women. The aim of this population-based study of women aged 25 to 50 was to assess the relationship between free androgen index (FAI) and cardiovascular risk factors in premenopausal women. Methods: A population-based survey of 396 premenopausal women with no hormonal treatment was undertaken as part of the Northern MONICA study. The study involved questionnaires, anthropometry and assays of testosterone and SHBG. Results: Increased FAI was associated with a number of cardiovascular risk factors in premenopausal women but this relationship was strongly affected by body mass index (BMI). After adjustment for age and BMI, FAI was significantly associated with increased systolic and diastolic blood pressures. Conclusion: Hyperandrogenism is associated with increased blood pressure and these findings emphasize the need to assess cardiovascular risk factors in women with hyperandrogenism of all ages.
Improving adjustments for older age in pre-hospital assessment and care
Rehn Marius
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2013, DOI: 10.1186/1757-7241-21-4
Abstract: Population estimates projects a significant increase in the geriatric population making elderly trauma patients more common. The geriatric trauma patients experience higher incidence of pre-existing medical conditions, impaired age-dependent physiologic reserve, use potent drugs and suffer from trauma system related shortcomings that influence outcomes. To improve adjustments for older age in pre-hospital assessment and care, several initiatives should be implemented. Decision-makers should make system revisions and introduce advanced point-of-care initiatives to improve outcome after trauma for the elderly.
A New Species of Roach of the Genus Kakerlac (Loboptera Auct.)From Southern Texas
James A. G. Rehn
Psyche , 1904, DOI: 10.1155/1904/75607
Das gestielte Myom - Zwei besondere Differentialdiagnosen
Rehn A,Hess T
Journal für Fertilit?t und Reproduktion , 2004,
Abstract: Zur pr operativen Abkl rung eines unklaren Unterbauchtumors stehen uns diverse Abkl rungsmethoden zur Verfügung. Trotzdem werden wir intraoperativ immer wieder überrascht. – Fall Nummer 1: 32j hrige Patientin, welche schon seit Jahren wegen bekannter Spondylolisthesis konservativ behandelt wurde. Ein Zufallsbefund im Rahmen der gyn kologischen Jahreskontrolle zeigte eine unklare Raumforderung im Bereich der rechten Adnexe. Sonographisch und in der MRT-Untersuchung wurde der Verdacht auf ein gestieltes Myom ge u ert, intraoperativ fand sich aber ein gro er retroperitonealer Tumor, welcher retrospektiv bereits auf lteren R ntgenbildern zu sehen war. Histologisch handelte es sich um ein Schwannom. – Fall Nummer 2: 46j hrige Patientin mit im Rahmen der gyn kologischen Jahreskontrolle festgestellter Raumforderung parauterin rechts. Pr operativ wurde mittels Ultraschall und Computertomographie die Diagnose eines gestielten Myoms gestellt. Intraoperativ fand sich ein kugeliger Tumor im Omentum majus, welcher histologisch die Diagnose einer leiomyomat sen Neoplasie des Omentum majus ergab. In beiden F llen wurde pr operativ die Diagnose eines gestielten Myoms gestellt, intraoperativ jedoch nicht best tigt. Die Differentialdiagnose des gestielten Myoms ist sehr breit und verlangt unbedingt den Nachweis eines Stiels durch bildgebende Verfahren. Au erdem l t sich anhand der beiden Fallbeispiele zeigen, da wir trotz vieler pr operativer Abkl rungsm glichkeiten nicht vor intraoperativen überraschungen gefeit sind.
Optimal Replica Placement in Tree Networks with QoS and Bandwidth Constraints and the Closest Allocation Policy
Veronika Rehn-Sonigo
Computer Science , 2007,
Abstract: This paper deals with the replica placement problem on fully homogeneous tree networks known as the Replica Placement optimization problem. The client requests are known beforehand, while the number and location of the servers are to be determined. We investigate the latter problem using the Closest access policy when adding QoS and bandwidth constraints. We propose an optimal algorithm in two passes using dynamic programming.
Nuclear medicine technologists are able to accurately determine when a myocardial perfusion rest study is necessary
Tr?g?rdh Elin,Johansson Liselott,Olofsson Camilla,Valind Sven
BMC Medical Informatics and Decision Making , 2012, DOI: 10.1186/1472-6947-12-97
Abstract: Background In myocardial perfusion scintigraphy (MPS), typically a stress and a rest study is performed. If the stress study is considered normal, there is no need for a subsequent rest study. The aim of the study was to determine whether nuclear medicine technologists are able to assess the necessity of a rest study. Methods Gated MPS using a 2-day 99mTc protocol for 121 consecutive patients were studied. Visual interpretation by 3 physicians was used as gold standard for determining the need for a rest study based on the stress images. All nuclear medicine technologists performing MPS had to review 82 training cases of stress MPS images with comments regarding the need for rest studies, and thereafter a test consisting of 20 stress MPS images. After passing this test, the nuclear medicine technologists in charge of a stress MPS study assessed whether a rest study was needed or not or if he/she was uncertain and wanted to consult a physician. After that, the physician in charge interpreted the images and decided whether a rest study was required or not. Results The nuclear medicine technologists and the physicians in clinical routine agreed in 103 of the 107 cases (96%) for which the technologists felt certain regarding the need for a rest study. In the remaining 14 cases the technologists were uncertain, i.e. wanted to consult a physician. The agreement between the technologists and the physicians in clinical routine was very good, resulting in a kappa value of 0.92. There was no statistically significant difference in the evaluations made by technicians and physicians (P = 0.617). Conclusions The nuclear medicine technologists were able to accurately determine whether a rest study was necessary. There was very good agreement between nuclear medicine technologists and physicians in the assessment of the need for a rest study. If the technologists can make this decision, the effectiveness of the nuclear medicine department will improve.
Exploiting Symmetry in Integer Convex Optimization using Core Points
Katrin Herr,Thomas Rehn,Achill Schürmann
Mathematics , 2012, DOI: 10.1016/j.orl.2013.02.007
Abstract: We consider convex programming problems with integrality constraints that are invariant under a linear symmetry group. To decompose such problems we introduce the new concept of core points, i.e., integral points whose orbit polytopes are lattice-free. For symmetric integer linear programs we describe two algorithms based on this decomposition. Using a characterization of core points for direct products of symmetric groups, we show that prototype implementations can compete with state-of-the-art commercial solvers, and solve an open MIPLIB problem.
On Lattice-Free Orbit Polytopes
Katrin Herr,Thomas Rehn,Achill Schürmann
Mathematics , 2014, DOI: 10.1007/s00454-014-9638-x
Abstract: Given a permutation group acting on coordinates of $\mathbb{R}^n$, we consider lattice-free polytopes that are the convex hull of an orbit of one integral vector. The vertices of such polytopes are called \emph{core points} and they play a key role in a recent approach to exploit symmetry in integer convex optimization problems. Here, naturally the question arises, for which groups the number of core points is finite up to translations by vectors fixed by the group. In this paper we consider transitive permutation groups and prove this type of finiteness for the $2$-homogeneous ones. We provide tools for practical computations of core points and obtain a complete list of representatives for all $2$-homogeneous groups up to degree twelve. For transitive groups that are not $2$-homogeneous we conjecture that there exist infinitely many core points up to translations by the all-ones-vector. We prove our conjecture for two large classes of groups: For imprimitive groups and groups that have an irrational invariant subspace.
Strategies for Replica Placement in Tree Networks
Yves Robert,Anne Benoit,Veronika Rehn
Computer Science , 2006,
Abstract: In this paper, we discuss and compare several policies to place replicas in tree networks, subject to server capacity and QoS constraints. The client requests are known beforehand, while the number and location of the servers are to be determined. The standard approach in the literature is to enforce that all requests of a client be served by the closest server in the tree. We introduce and study two new policies. In the first policy, all requests from a given client are still processed by the same server, but this server can be located anywhere in the path from the client to the root. In the second policy, the requests of a given client can be processed by multiple servers. One major contribution of this paper is to assess the impact of these new policies on the total replication cost. Another important goal is to assess the impact of server heterogeneity, both from a theoretical and a practical perspective. In this paper, we establish several new complexity results, and provide several efficient polynomial heuristics for NP-complete instances of the problem. These heuristics are compared to an absolute lower bound provided by the formulation of the problem in terms of the solution of an integer linear program.
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