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"SVENSSON, Leif"
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\"The most photographed British star of the '80s alongside Princess Diana and Margaret Thatcher. Not since the Beatles has a British personality been so well known internationally, across a complete cross-section of ages, genders, races, and religions. Now, for the very first time, Samantha Fox has decided to tell the whole, and sometimes painful, story of the bullied North London girl who managed to captivate an entire world. My first memory is of an explosion and the smell of burnt flesh. With those words, following a prologue in which readers are introduced to her backstage in 2015, Samantha Fox begins her story. Thoughts of Myra the love of her life who has been battling an aggressive form of cancer for almost two years whirl through her mind, then shortly she takes to the stage once more, to sing Touch Me, the song which made her world famous almost 30 years earlier. Samantha Fox's autobiography is a captivating tale about a fighter who has gone through hell more than once, but who has always come out stronger; someone who has remained in the public's consciousness for almost four decades now and who continues to play to sold-out crowds across the world.\"--Publisher's description.
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Mobile-Phone Dispatch of Laypersons for CPR in Out-of-Hospital Cardiac Arrest
Bystander-initiated cardiopulmonary resuscitation can increase survival among patients with out-of hospital cardiac arrest. In this study, a mobile-phone positioning system to dispatch trained volunteers significantly increased rates of bystander-initiated CPR.
Bystander-initiated cardiopulmonary resuscitation (CPR) before the arrival of emergency-medical-services (EMS) personnel is associated with a rate of survival among patients with out-of-hospital cardiac arrest that is up to three times as high as the rate among patients who do not receive such assistance.
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Low rates of bystander-initiated CPR are a major obstacle to improved survival rates.
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The usual approach to increase rates of bystander-initiated CPR has been to train as much of the public as possible.
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However, this approach is associated with substantial costs and uncertain effects on rates of bystander-initiated CPR.
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With the use of a mobile-phone positioning . . .
Journal Article
Early Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest
This study examined whether training in cardiopulmonary resuscitation increases the frequency of bystander CPR and the rate of survival. CPR performed before the arrival of emergency medical services was associated with a substantially greater 30-day survival rate.
Out-of-hospital cardiac arrest is a major public health concern, given that there are approximately 420,000 cases in the United States and 275,000 cases in Europe annually.
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Decreasing the time to treatment is crucial for improving outcomes in cases of cardiac arrest.
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As stated in American and European guidelines, the most important response measures that currently can be taken outside a hospital setting are recognizing early that a cardiac arrest is occurring, placing an alarm call, performing cardiopulmonary resuscitation (CPR), and performing defibrillation.
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Globally, CPR is taught to millions of people each year. In Sweden, more than 3 . . .
Journal Article
The RESPONDER trial: a feasibility study of an early intervention model deploying community first responders to administer intranasal naloxone in suspected opioid overdoses in Skåne, Sweden
IntroductionOpioid use continues to cause harm and fatalities worldwide, despite ongoing preventive efforts. Early administration of the antidote naloxone can reverse potentially fatal opioid overdoses. Naloxone distribution programmes have increased survival across regions; however, additional efforts are needed to reduce opioid overdose mortality. One approach is to expand naloxone availability within communities.Methods and analysisThe feasibility trial RESPONDER (REgion Skåne Preventing Overdose deaths through Naloxone Distribution with Emergency Runners) introduces a unique smartphone alerting system with community first responders (CFRs) dispatched to suspected opioid overdoses, in addition to the dispatch of regular emergency medical services (EMS). The aim is to investigate if trained CFRs can successfully recognise and reverse overdoses caused by opioids, prior to EMS arrival. The CFRs will be equipped with nasal naloxone and introduced to a novel naloxone algorithm during a study-specific course prior to participation. The course will offer practical training in basic life support and first aid, and it will also assess competence in the low-arousal approach, as well as the legal and ethical aspects of being a CFR.Main outcomes of the trial are feasibility, acceptability and safety. The trial will be performed in the region of Skåne, Sweden, between 1 September 2025 and 31 August 2027, with every CFR followed for up to 12 months.Ethics and disseminationThe trial has been approved by the Swedish Ethical Review Authority (file number 2024–05887-01). Written informed consent is required from participating CFRs. This is also required of overdose survivors to allow the collection of clinical data from hospital records.Information regarding the project and recruitment will be disseminated via social media, news media, through the healthcare region’s communication channels and within public transportation hubs. Outcomes and analyses will be submitted to peer-reviewed journals.ClinicalTrials.gov-IDNCT07079241
Journal Article
Compression-Only CPR or Standard CPR in Out-of-Hospital Cardiac Arrest
In a randomized clinical trial involving patients with out-of-hospital cardiac arrest, 30-day survival rates were similar when compression-only CPR was used and when standard CPR (compression and ventilation) was used. The results provide further support for a compression-only strategy.
Emergency medical dispatch centers are crucial in supporting and giving instructions to witnesses or bystanders who call for help for patients with cardiac arrest before the arrival of emergency medical services (EMS) personnel.
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Telephone instructions given for cardiopulmonary resuscitation (CPR) seem to be given predominantly for CPR involving chest compression.
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Using an animal model, Berg and colleagues
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found that compression-only CPR and standard CPR (i.e., CPR involving both compression and ventilation) have similar efficacy. In a clinical study in which dispatchers gave randomly assigned instructions to callers for aid to patients with cardiac arrest — to attempt resuscitation with the . . .
Journal Article
Increase in survival and bystander CPR in out-of-hospital shockable arrhythmia: bystander CPR and female gender are predictors of improved outcome. Experiences from Sweden in an 18-year perspective
ObjectivesIn a national perspective, to describe survival among patients found in ventricular fibrillation or pulseless ventricular tachycardia witnessed by a bystander and with a presumed cardiac aetiology and answer two principal questions: (1) what are the changes over time? and (2) which are the factors of importance?DesignObservational register study.SettingSweden.PatientsAll patients included in the Swedish Out of Hospital Cardiac Arrest Register between 1 January 1990 and 31 December 2009 who were found in bystander-witnessed ventricular fibrillation with a presumed cardiac aetiology.InterventionsBystander cardiopulmonary resuscitation (CPR) and defibrillation.Main outcome measuresSurvival to 1 month.ResultsIn all, 7187 patients fulfilled the set criteria. Age, place of out-of-hospital cardiac arrest (OHCA) and gender did not change. Bystander CPR increased from 46% to 73%; 95% CI for OR 1.060 to 1.081 per year. The median delay from collapse to defibrillation increased from 12 min to 14 min (p for trend 0.0004). Early survival increased from 28% to 45% (95% CI 1.044 to 1.065) and survival to 1 month increased from 12% to 23% (95% CI 1.058 to 1.086). Strong predictors of early and late survival were a short interval from collapse to defibrillation, bystander CPR, female gender and OHCA outside the home.ConclusionIn a long-term perspective in Sweden, survival to 1 month after ventricular fibrillation almost doubled. This was associated with a marked increase in bystander CPR. Strong predictors of outcome were a short delay to defibrillation, bystander CPR, female gender and place of collapse.
Journal Article
Fetal alcohol spectrum disorders from childhood to adulthood: a Swedish population-based naturalistic cohort study of adoptees from Eastern Europe
BackgroundFetal alcohol spectrum disorders (FASD) are a global health concern. To further understand FASD in adulthood is a major public health interest.ObjectiveTo describe the clinical characteristics of young adults with FASD adopted from orphanages to a socially more favourable and stable rearing environment as children.DesignProspective observational cohort studySettingWestern SwedenParticipantsA population-based cohort of 37 adoptees diagnosed with FASD in childhood.Outcome measuresAssessment consisted of clinical evaluations of social, medical, psychiatric, neuropsychological, adaptive and ophthalmological status by a physician, ophthalmologist, orthoptist and psychologist.ResultsOut of 37 adoptees with FASD, 36 (15 females) were evaluated at a median age of 22 years (range 18–28) and a mean follow-up time of 15.5 years (range 13–17). Twenty (56%) were dependent on social support. Sexual victimisation was reported by nine (26%). In 21 individuals with fetal alcohol syndrome, growth restriction in height and head circumference of approximately −1.8 SD persisted into adulthood. Of 32 examined, 22 (69%) had gross motor coordination abnormalities. High blood pressure was measured in nine (28%). Ophthalmological abnormalities were found in 29 of 30 (97%). A median IQ of 86 in childhood had declined significantly to 71 by adulthood (mean difference: 15.5; 95% CI 9.5–21.4). Psychiatric disorders were diagnosed in 88%, most commonly attention deficit hyperactivity disorder (70%). Three or more disorders were diagnosed in 48%, and 21% had attempted suicide. The median Clinical Global Impression-Severity score was 6 = ‘severely ill’.ConclusionMajor cognitive impairments, psychiatric morbidity, facial dysmorphology, growth restriction and ophthalmological abnormalities accompanies FASD in adulthood. Recognition of FASD in childhood warrants habilitation across the lifespan.
Journal Article
Outcome of exercise-related out-of-hospital cardiac arrest is dependent on location: Sports arenas vs outside of arenas
The chance of surviving an out-of-hospital cardiac arrest (OHCA) seems to be increased if the cardiac arrests occurs in relation to exercise. Hypothetically, an exercise-related OHCA at a sports arena would have an even better prognosis, because of an increased likelihood of bystander cardiopulmonary resuscitation (CPR) and higher availability of automated external defibrillators (AEDs). The purpose of the study was to compare survival rates between exercise-related OHCA at sports arenas versus outside of sports arenas.
Data from all treated exercise-related OHCA outside home reported to the Swedish Register of Cardiopulmonary Resuscitation (SRCR) from 2011 to 2014 in 10 counties of Sweden was analyzed (population 6 million). The registry has in those counties a coverage of almost 100% of all OHCAs.
3714 cases of OHCA outside of home were found. Amongst them, 268(7%) were exercise-related and 164 (61.2%) of those occurred at sports arenas. The 30-day survival rate was higher for exercise-related OHCA at sports arenas compared to outside (55.7% vs 30.0%, p<0.0001). OHCA-victims at sports arenas were younger (mean age±SD 57.6±16.3 years compared to 60.9±17.0 years, p = 0.05), less likely female (4.3% vs 12.2%, p = 0.02) and had a higher frequency of shockable rhythm (73.0% vs 54.3%, p = 0.004). OHCAs at arenas were more often witnessed (83.9% vs 68.9%, p = 0.007), received bystander CPR to a higher extent (90.0% vs 56.8%, p<0.0001) and the AED-use before EMS-arrival was also higher in this group (29.8% vs 11.1%, p = 0.009).
The prognosis is markedly better for exercise-related OHCA occurring at sports arenas compared to outside. Victims of exercise-related OHCA at sports arenas are more likely to receive bystander CPR and to be connected to a public AED. These findings support an increased use of public AEDs and implementation of Medical Action Plans (MAP), to possibly increase survival of exercise-related OHCA even further.
Journal Article
Time to intra-arrest therapeutic hypothermia in out-of-hospital cardiac arrest patients and its association with neurologic outcome: a propensity matched sub-analysis of the PRINCESS trial
PurposeTo study the association between early initiation of intra-arrest therapeutic hypothermia and neurologic outcome in out-of-hospital cardiac arrest. MethodsA prespecified sub-analysis of the PRINCESS trial (NCT01400373) that randomized 677 bystander-witnessed cardiac arrests to transnasal evaporative intra-arrest cooling initiated by emergency medical services or cooling started after hospital arrival. Early cooling (intervention) was defined as intra-arrest cooling initiated < 20 min from collapse (i.e., ≤ median time to cooling in PRINCESS). Propensity score matching established comparable control patients. Primary outcome was favorable neurologic outcome, Cerebral Performance Category (CPC) 1–2 at 90 days. Complete recovery (CPC 1) was among secondary outcomes.ResultsIn total, 300 patients were analyzed and the proportion with CPC 1–2 at 90 days was 35/150 (23.3%) in the intervention group versus 24/150 (16%) in the control group, odds ratio (OR) 1.92, 95% confidence interval (CI) 0.95–3.85, p = .07. In patients with shockable rhythm, CPC 1–2 was 29/57 (50.9%) versus 17/57 (29.8%), OR 3.25, 95%, CI 1.06–9.97, p = .04. The proportion with CPC 1 at 90 days was 31/150 (20.7%) in the intervention group and 17/150 (11.3%) in controls, OR 2.27, 95% CI 1.12–4.62, p = .02. In patients with shockable rhythms, the proportion with CPC 1 was 27/57 (47.4%) versus 12/57 (21.1%), OR 5.33, 95% CI 1.55–18.3, p = .008.ConclusionsIn the whole study population, intra-arrest cooling initiated < 20 min from collapse compared to cooling initiated at hospital was not associated with improved favorable neurologic outcome. In the subgroup with shockable rhythms, early cooling was associated with improved favorable outcome and complete recovery.
Journal Article