Genbrug og genanvendelse af plast i fiskeredskaber i nordiske småsamfund

Poulsen, Tomas Sander

doi:10.6027/na2020-902

Cited by 2 publications

(1 citation statement)

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“…First, the Danish Laboratory Database was accessed to identify all 2008-2018 lumbar punctures registered by the use of Nomenclature for Properties and Units (NPU) codes for cerebrospinal fluid (CSF) analyses (eTable 1 in the Supplement). After establishment in 2008, this registry has steadily expanded and now includes most major biochemical laboratories in Denmark since 2015, corresponding to approximately 80% of the population of Denmark . Each lumbar puncture was individually numbered by grouping NPU codes according to the unique personal identifier of each Danish resident and the date of analysis.…”

Section: Methodsmentioning

confidence: 99%

Association of Lumbar Puncture With Spinal Hematoma in Patients With and Without Coagulopathy

Bodilsen

Mariager

Vestergaard

et al. 2020

JAMA

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IMPORTANCE Coagulopathy may deter physicians from performing a lumbar puncture.OBJECTIVE To determine the risk of spinal hematoma after lumbar puncture in patients with and without coagulopathy.DESIGN, SETTING, AND PARTICIPANTS Danish nationwide, population-based cohort study using medical registries to identify persons who underwent lumbar puncture and had cerebrospinal fluid analysis (January 1, 2008-December 31, 2018; followed up through October 30, 2019). Coagulopathy was defined as platelets lower than 150 × 10 9 /L, international normalized ratio (INR) greater than 1.4, or activated partial thromboplastin time (APTT) longer than 39 seconds.EXPOSURES Coagulopathy at the time of lumbar puncture.MAIN OUTCOMES AND MEASURES Thirty-day risk of spinal hematoma. Risks were provided as numbers and percentages with 95% CIs. Secondary analyses included risks of traumatic lumbar puncture (>300 × 10 6 erythrocytes/L after excluding patients diagnosed with subarachnoid hemorrhage). Adjusted hazard rate ratios (HRs) were computed using Cox regression models.RESULTS A total of 83 711 individual lumbar punctures were identified among 64 730 persons (51% female; median age, 43 years [interquartile range, 22-62 years]) at the time of the procedure. Thrombocytopenia was present in 7875 patients (9%), high INR levels in 1393 (2%), and prolonged APTT in 2604 (3%). Follow-up was complete for more than 99% of the study participants. Overall, spinal hematoma occurred within 30 days for 99 of 49 526 patients (0.20%; 95% CI, 0.16%-0.24%) without coagulopathy vs 24 of 10 371 patients (0.23%; 95% CI, 0.15%-0.34%) with coagulopathy. Independent risk factors for spinal hematoma were male sex (adjusted hazard ratio [HR], 1.72; 95% CI, 1.15-2.56), those aged 41 through 60 years (adjusted HR, 1.96; 95% CI, 1.01-3.81) and those aged 61 through 80 years (adjusted HR, 2.20; 95% CI, 1.12-4.33). Risks did not increase significantly according to overall severity of coagulopathy, in subgroup analyses of severity of coagulopathy by pediatric specialty or medical indication (infection, neurological condition, and hematological malignancy), nor by cumulative number of procedures. Traumatic lumbar punctures occurred more frequently among patients with INR levels of 1.5 to 2.0 (36.8%; 95% CI, 33.3%-40.4%), 2.1 to 2.5 (43.7%; 95% CI, 35.8%-51.8%), and 2.6 to 3.0 (41.9% 95% CI 30.5-53.9) vs those with normal INR (28.2%; 95% CI, 27.7%-28.75%). Traumatic spinal tap occurred more often in patients with an APTT of 40 to 60 seconds (26.3%; 95% CI, 24.2%-28.5%) vs those with normal APTT (21.3%; 95% CI, 20.6%-21.9%) yielding a risk difference of 5.1% (95% CI, 2.9%-7.2%). CONCLUSIONS AND RELEVANCEIn this Danish cohort study, risk of spinal hematoma following lumbar puncture was 0.20% among patients without coagulopathy and 0.23% among those with coagulopathy. Although these findings may inform decision-making about lumbar puncture by describing rates in this sample, the observed rates may reflect bias due to physicians selecting relatively low-risk patients for ...

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Section: Methodsmentioning

confidence: 99%

Association of Lumbar Puncture With Spinal Hematoma in Patients With and Without Coagulopathy

Bodilsen

Mariager

Vestergaard

et al. 2020

JAMA

View full text Add to dashboard Cite

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Review of plastic pollution policies of Arctic countries in relation to seabirds

Linnebjerg

Baak

Barry

et al. 2021

FACETS

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Marine plastic is a ubiquitous environmental problem that can have an impact on a variety of marine biota, such as seabirds, making it an important concern for scientists and policy makers. Although research on plastic ingestion by seabirds is increasing, few studies have examined policies and long-term monitoring programs to reduce marine plastic in the Arctic. This paper provides a review of international, national, and regional policies and long-term monitoring programs that address marine plastic in relation to seabirds in the Arctic countries: Canada, the Kingdom of Denmark (Greenland and the Faroe Islands), Finland, Iceland, Norway, the Russian Federation, Sweden, and the United States of America. Results show that a broad range of international, national, regional and local policies address marine debris, specifically through waste management and the prevention of pollution from ships. However, few policies directly address seabirds and other marine biota. Further, policies are implemented inconsistently across regions, making it difficult to enforce and monitor the efficacy of these policies given the long-range transport of plastic pollution globally. To reduce marine plastic pollution in the Arctic environment, pan-Arctic and international collaboration is needed to implement standardized policies and long-term monitoring programs for marine plastic in the Arctic and worldwide.

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Genbrug og genanvendelse af plast i fiskeredskaber i nordiske småsamfund

Cited by 2 publications

References 0 publications

Association of Lumbar Puncture With Spinal Hematoma in Patients With and Without Coagulopathy

Association of Lumbar Puncture With Spinal Hematoma in Patients With and Without Coagulopathy

Review of plastic pollution policies of Arctic countries in relation to seabirds

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