Periprocedural prognostic factors in coronary interventions – retrospective studies

Background: Approximately 11,000 revascularization procedures, either percutaneous coronary interventions (PCI) or coronary artery bypass grafting surgery (CABG), are performed yearly in Finland for coronary artery disease. Periprocedural risk factors for mortality and morbidity as well as long-term outcome have been extensively studied in general populations undergoing revascularization. Treatment choice between PCI and CABG in many high risk groups and risk-stratification, however, needs clarification and there is still room for improvement in periprocedural outcomes. Materials and methods: Cohorts of patients from Finnish hospitals revascularized between 2001 and 2011 were retrospectively analyzed. Patient records were reviewed for baseline variables and postprocedural outcomes (stroke, myocardial infarction, quality of life measured by the EQ-5D –questionnaire, repeat revascularization, bleeding episodes). Data on date and mode of death was acquired from Statistics Finland. Statistical analysis was performed to identify predictors of adverse events and compare procedures. Results: Postoperative administration of blood products (red blood cells, fresh frozen plasma, platelets) after isolated CABG independently and dose-dependently increases the risk of stroke. Patients 80 years or older who underwent CABG had better survival at 5 years compared to those who underwent PCI. After adjusting for baseline differences survival was similar. Patients on oral anticoagulation (OAC) for atrial fibrillation (AF) treated with CABG had better survival and overall outcome at 3 years compared to PCI patients. There was no difference in incidence of stroke or bleeding episodes. Differences in outcome remained significant after adjusting for propensity score. Lower health-related quality of life (HRQOL) scores as measured by the visual analogue scale (VAS) of the EQ-5D questionnaire at 6 months after CABG predicted later major adverse cardiac and cerebrovascular events (MACCE). Deteriorating function and VAS scores between 0 and 6 months on the EQ-5D also independently predicted later MACCE. Conclusions: Administration of blood products can increase the risk of stroke after CABG and liberal use of transfusions should be avoided. In the frail subpopulations of patients on OAC and octogenarians CABG appears to offer superior long-term outcome as compared to PCI. Deteriorating HRQOL scores predict later adverse events after CABG. Keywords: percutaneous coronary intervention, coronary artery bypass grafting, age over 80, transfusion, anticoagulants, coronary artery disease, health-related quality of life, outcome.

Production of calves following nonsurgical transfer of fresh and refrigerated bovine demi-embryos

Selostus: Vasikoiden tuottaminen tuoreilla ja kylmäsäilytetyillä halkaistuilla alkioilla

Understorey vegetation in fresh and Herb-Rich upland forests in South-west Lapland

Summary

Effect of supplemental vitamin E on the performance of growing-finishing pigs fed stored versus freshly harvested barley and on the storage stability and eating quality of frozen pork

Lihasikojen E-vitamiinin tarve ruokittaessa vastapuidulla ohralla ja rehuun lisätyn E-vitamiinin vaikutus lihan pakastussäilyvyyteen ja syöntilaatuun

Whole sales market for fresh potato in Finland

Selostus: Suomen ruokaperunamarkkinoiden toimivuus

Effect of thawing duration and temperature on field performance of frozen-stored Norway spruce container seedlings

Abstract

Cutting of Frozen Wood

The objective of this master's thesis was to develop a system for measuring the cutting forces of frozen wood. In northern parts of the world cuttingof frozen wood is one of the major problem. During winter and early spring the temperature inside the wood cells will fall below Zero degrees that strongly influences on the properties of the wood. These variations of properties will effects on the blade nomenclature while cutting the frozen wood. However the end results will cause uneven cutting forces. Cutting forces, Chip formation, wearing of the blade and the quality of the machined surface are difficult task. In this project we are attempting to find the variation of cutting forces and properties of frozen wood at four different temperatures (-20 , -10, 0 and + 10 degrees). The linear planning machine was used for measuring the cuttingforces. The cutting was done parallel to the long axis of wood due to the nature of pine wood and the structure of the plane. A considerable amount of work andtime was used for collecting and processing the numerical information from the sensors of the measuring system. There were some alterations suggested to the construction of the plane and the sensor system.

Travel changes thought and men : a fresh perspective on the travels of a literary icon

Kirjallisuusarvostelu