Revascularization Treatment of Emergency Patients with Acute ST-Segment Elevation Myocardial Infarction in Switzerland: Results from a Nationwide, Cross-Sectional Study in Switzerland for 2010-2011

BACKGROUND: Cardiovascular diseases are the leading cause of death worldwide and in Switzerland. When applied, treatment guidelines for patients with acute ST-segment elevation myocardial infarction (STEMI) improve the clinical outcome and should eliminate treatment differences by sex and age for patients whose clinical situations are identical. In Switzerland, the rate at which STEMI patients receive revascularization may vary by patient and hospital characteristics. AIMS: To examine all hospitalizations in Switzerland from 2010-2011 to determine if patient or hospital characteristics affected the rate of revascularization (receiving either a percutaneous coronary intervention or a coronary artery bypass grafting) in acute STEMI patients. DATA AND METHODS: We used national data sets on hospital stays, and on hospital infrastructure and operating characteristics, for the years 2010 and 2011, to identify all emergency patients admitted with the main diagnosis of acute STEMI. We then calculated the proportion of patients who were treated with revascularization. We used multivariable multilevel Poisson regression to determine if receipt of revascularization varied by patient and hospital characteristics. RESULTS: Of the 9,696 cases we identified, 71.6% received revascularization. Patients were less likely to receive revascularization if they were female, and 80 years or older. In the multivariable multilevel Poisson regression analysis, there was a trend for small-volume hospitals performing fewer revascularizations but this was not statistically significant while being female (Relative Proportion = 0.91, 95% CI: 0.86 to 0.97) and being older than 80 years was still associated with less frequent revascularization. CONCLUSION: Female and older patients were less likely to receive revascularization. Further research needs to clarify whether this reflects differential application of treatment guidelines or limitations in this kind of routine data.

St. Rupertus-Büchlein : der heilige Rupertus von Bingen, die heilige Bertha, seine Mutter, der heilige Wigbert, sein Lehrer und Erzieher ; ihr Leben, ihre Verehrung und ihre Reliquien

von Peter Bruder

Historical sketch of the Flathead Indian nation from the year 1813 to 1890. Embracing the history of the establishment of St. Mary's Indian mission in the Bitter Root Valley, Mont. With sketches of the missionary life of Father Ravalli and other early missionaries, wars of the Blackfeet and Flatheads, and sketches of history, trapping and trading in the early days ...

Mode of access: Internet.

Minuajimouin gaizhibiiget au St. John : the Gospel of St. John in the language of the Ojibwa Indians.

United Bible Societies language: Ojibway: Southern.

Johann Jakob Scherrer, Pfarrer in Hundwil und Georg Kaspar Scherrer, Antistes in St. Gallen, oder Lebensgeschichte und Karakteristik des Vaters und des Sohns. Zum Andenken an den verewigten Georg Kaspar Scherrer, Antistes der evangelischen Geistlichkeit des Kantons St. Gallen.

Mode of access: Internet.

Sketches from St. George's Fields : Second series

Mode of access: Internet.

Critical examination of the life of St. Paul /

The French edition (London, 1770) has title "Examen critique de la vie et des ouvrages de saint Paul [a free translation by Baron P.H.D. von Holbach of P. Annet's 'History and character of St. Paul, examined'] Avec une dissertation sur saint Pierre, par feu M. Boulanger." cf. Brit. Mus. Catalogue.

Life and letters of James David Forbes, F.R.S., D.C.L., LL. D., late principal of the United college in the University of St. Andrews ...

"List of Principal Forbes' scientific writings": p. [567]-577.

St. John’s wort and Kava in treating major depressive disorder with comorbid anxiety : a randomised double-blind placebo-controlled pilot trial

Objective - We report the first randomised controlled trial (RCT) using a combination of St. John’s wort (SJW) and Kava for the treatment of major depressive disorder (MDD) with comorbid anxiety. Methods - Twenty-eight adults with MDD and co-occurring anxiety were recruited for a double-blind RCT. After a placebo run-in of 2 weeks, the trial had a crossover design testing SJW and Kava against placebo over two controlled phases, each of 4 weeks. The primary analyses used intention-to-treat and completer analyses. Results - On both intention-to-treat ( p¼0.047) and completer analyses ( p¼0.003), SJW and Kava gave a significantly greater reduction in self-reported depression on the Beck Depression Inventory (BDI-II) over placebo in the first controlled phase. However, in the crossover phase, a replication of those effects in the delayed medication group did not occur. Nor were there significant effects on anxiety or quality of life. Conclusion - There was some evidence of antidepressant effects using SJW and Kava in a small sample with comorbid anxiety. Possible explanations for the absence of anxiolysis may include a potential interaction with SJW, the presence of depression, or an inadequate dose of Kava.

Sandstone and rust : designing the qualities of Sydney harbour

Landscape architecture is built from place. What place is depends how one reads a site, which then determines what qualities are engaged with, and how they are engaged with, by design. Sydney Harbour is one of the most celebrated and distinctive harbours in the world. The qualities of the indigenous, pre-European landscape have been referred to regularly in the history of Australian landscape architecture as a source of inspiration for a truly Australian language of landscape design. A range of different models of such an Australian language have been proposed and tested on landscape design sites on Sydney Harbour, models that are in a discourse both with the specific landscape and with local landscape architecture theory and practice, particularly in relation to ideas of ‘appropriateness’ in Australian landscape architecture. This essay examines arguments from the 1970s that proposed a ‘palette’ approach to appropriateness, along with a key project from that period, Long Nose Point Park, that demonstrates this approach. The essay will then discuss three recent projects on the Harbour and demonstrate that these projects transcend the ‘palette’ approach by engaging with specific relationships on their sites (a ‘relationships’ approach) that are tied to the cultural occupation of Sydney Harbour. Along the way, the reader will be introduced to the key figures and history of landscape architecture in Australia, and to the geography of Sydney Harbour with its various ecologies and milieus

Kava and St. John's wort : current evidence for use in mood and anxiety disorders

Background: Mood and anxiety disorders pose significant health burdens on the community. Kava and St John’s wort (SJW) are the most commonly used herbal medicines in the treatment of anxiety and depressive disorders, respectively. Objectives: To conduct a comprehensive review of kava and SJW, to review any evidence of efficacy, mode of action, pharmacokinetics, safety and use in Major Depressive Disorder (MDD), Bipolar Disorder (BP), Seasonal Affective Disorder (SAD), Generalized Anxiety Disorder (GAD), Social Phobia (SP), Panic Disorder (PD), Obsessive-Compulsive Disorder (OCD), and Post Traumatic Stress Disorder (PTSD). Methods: A systematic review was conducted using the electronic databases MEDLINE, CINAHL, and The Cochrane Library during late 2008. The search criteria involved mood and anxiety disorder search terms in combination with kava, Piper methysticum, kavalactones, St John’s wort, Hypericum perforatum, hypericin and hyperforin. Additional search criteria for safety, pharmacodynamics , and pharmacokinetics was employed. A subsequent forward search was conducted of the papers using Web of Science cited reference search. Results: Current evidence supports the use of SJW in treating mild-moderate depression, and for kava in treatment of generalized anxiety. In respect to the other disorders, only weak preliminary evidence exists for use of SJW in SAD. Currently there is no published human trial on use of kava in affective disorders, or in OCD, PTSD, PD or SP. These disorders constitute potential applications that warrant exploration. Conclusions: Current evidence for herbal medicines in the treatment of depression and anxiety only supports the use of Hypericum perforatum for depression, and Piper methysticum for generalized anxiety.