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[Adherence to the national guidelines regarding referral of patients with knee osteoarthritis to orthopedic consultation].
Lakartidningen Pub Date : 2025-03-11
Daniel Broman, Lisa Andersson, Susanne Beischer, David Sundemo, Olof Thoreson, Maziar Mohaddes
{"title":"[Adherence to the national guidelines regarding referral of patients with knee osteoarthritis to orthopedic consultation].","authors":"Daniel Broman, Lisa Andersson, Susanne Beischer, David Sundemo, Olof Thoreson, Maziar Mohaddes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of the study was to investigate: 1) the proportion of referrals from primary care to orthopedic consultations that included the information requested by the national guidelines for patients with knee osteoarthritis, and 2) the proportion of referrals that specified whether patients had completed first-line treatment. A total of 140 referrals were examined. None of the referrals adhered fully to the national guidelines, and none included information on whether the patient had completed first-line treatment. This suggests that the referral process for this patient group needs to be reviewed and improved. We propose three possible changes regarding the referral process, including an enhanced role for physical therapists and the patients themselves and a digital referral platform enabling easier communication between different professions.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Are we hopefully on the way to eradicating HPV-related cancer?]
Lakartidningen Pub Date : 2025-03-10
Arne Wikström
{"title":"[Are we hopefully on the way to eradicating HPV-related cancer?]","authors":"Arne Wikström","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An interesting article in this issue of Läkartidningen argues for the benefit of a broad HPV vaccination with catch-up vaccination also for men, and sheds more light on HPV-related cancer in men. There has been an increase of HPV-related anal and oropharyngeal cancer in recent years, but no screening methods for these cancers have been implemented. A gender neutral catch-up vaccination would help to decrease the burden of oncogenic HPV in society, and would also be beneficial for females. Swedish authorities have now come to the conclusion that catch-up vaccination of men would be cost-effective, a decision that we strongly support.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Catch-up vaccination prevents HPV infection and related precancers when given up to age 26].
Lakartidningen Pub Date : 2025-03-10
Christina Carlander, Christer Borgfeldt, Lalle Hammarstedt Nordenvall
{"title":"[Catch-up vaccination prevents HPV infection and related precancers when given up to age 26].","authors":"Christina Carlander, Christer Borgfeldt, Lalle Hammarstedt Nordenvall","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>HPV-related cancers in men, particularly anal and oropharyngeal cancers, are increasing in Sweden and globally. Men who have sex with men, trans persons and people living with HIV are at especially high risk. HPV vaccination effectively prevents HPV infection and related precancers when given up to age 26. The Public Health Agency of Sweden makes the assessment that catch-up vaccination of unvaccinated males up to 26 years of age is likely to be cost-effective. New international guidelines recommend annual anal cancer screening for high-risk groups from ages 35-45. There are no guidelines for anal cancer screening in Sweden, and screening capacity in Sweden is limited. Vaccinating men not only protects them individually but also indirectly benefits women by reducing HPV transmission and strengthening herd immunity. Increased vaccination coverage and improved screening methods are crucial to reduce the burden of HPV-related cancers in men and accelerate the elimination of cervical cancer.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ABC om Psykiatrisk diagnostik.
Lakartidningen Pub Date : 2025-03-07
Johan Bengtsson, Christian Rück, Linda Steinholtz, Mats Adler
{"title":"ABC om Psykiatrisk diagnostik.","authors":"Johan Bengtsson, Christian Rück, Linda Steinholtz, Mats Adler","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Abortion after week 18].
Lakartidningen Pub Date : 2025-02-25
Lotti Helström
{"title":"[Abortion after week 18].","authors":"Lotti Helström","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A woman has the right to have an abortion without declaring any reason for it until the eighteenth week of the pregnancy. After that, abortion can be allowed upon application to the Legal Council of the National Board of Health and Welfare.   The number of abortions allowed for social reasons has been stable until 2020, when an increase of refusals occurred. The increase coincided with changes in meeting routines for the council.  The procedure for handling requests for abortion is problematic. Opportunities for the members of the council to discuss are scarce. No reasons for denial of abortion are communicated and there are no minutes from the meetings.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[The Swedish Registry of Cardiopulmonary Resuscitation - improvement through measurement].
Lakartidningen Pub Date : 2025-02-20
Araz Rawshani, Anneli Strömsöe, Solveig Aune, Johan Israelsson, Per Nordberg, Johan Herlitz
{"title":"[The Swedish Registry of Cardiopulmonary Resuscitation - improvement through measurement].","authors":"Araz Rawshani, Anneli Strömsöe, Solveig Aune, Johan Israelsson, Per Nordberg, Johan Herlitz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Swedish Registry of Cardiopulmonary Resuscitation started in 1990 and records the vast majority of resuscitation attempts in Sweden. The registry aims to monitor and improve the links in the chain of survival. The registry charts critical events at the time of resuscitation as well as the subsequent follow-up of initial survivors concerning their ongoing treatment, long-term survival, and quality of life. Several quality indicators that involve the delay time to treatment and survival have demonstrated improvements in the treatment and outcomes since the start of the registry. Data from the registry are being used to enable the improvement through measurement principle. A doubling in survival is noted for out-of-hospital cardiac arrest, despite an increased ambulance response time and a diminishing prevalence of cardiac etiology, resulting in a decreased incidence of ventricular fibrillation as the first recorded rhythm among these victims. These factors may underestimate the true improvement of survival rates after cardiac arrest in Sweden.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Treatment of freezing cold injuries].
Lakartidningen Pub Date : 2025-02-19
Cathrine Gennert Jakobsson, Helge Brändström, Maria Truedson, Henrik Hedelin
{"title":"[Treatment of freezing cold injuries].","authors":"Cathrine Gennert Jakobsson, Helge Brändström, Maria Truedson, Henrik Hedelin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The keys to successful treatment of freezing cold injuries are proper recognition and grading of the injury, followed by appropriate treatment within the first 24 hours. In the latter stages, challenges remain but are less time sensitive. The thawing process, in a water bath with a temperature of 37-39°C, is painful and requires ambitious pain relief. Thawing initiates an inflammation cascade at the cellular level resulting in micro embolies disrupting the micro-circulation. This mechanism explains why more severe frostbite injuries can be successfully treated with thrombolytic therapy and drugs such as iloprost and NSAID. These treatments must, for the same reason, be initiated within the first days after thawing. Imaging methods such as angiography, CT or bone scintigraphy give valuable added information to complement clinical examination after thawing. Proper wound care is of essence and aggressive surgery, such as amputation, should be postponed until definite clinical demarcation of necrosis is established.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Chronic thromboembolic pulmonary hypertension].
Lakartidningen Pub Date : 2025-02-11
Kasper Andersen, Bertil Larsson, Erik Björklund, Eva Mathilda Bergman, Gerhard Vikström, Charlotte Ebeling Barbier
{"title":"[Chronic thromboembolic pulmonary hypertension].","authors":"Kasper Andersen, Bertil Larsson, Erik Björklund, Eva Mathilda Bergman, Gerhard Vikström, Charlotte Ebeling Barbier","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chronic thromboembolic pulmonary hypertension (CTEPH) can develop subsequent to acute pulmonary embolism, with exertional dyspnea being the predominant symptom. Initial evaluation of CTEPH patients should prioritize surgical intervention via pulmonary thromboendarterectomy (PEA). For cases where surgical intervention is not feasible, balloon pulmonary angioplasty (BPA) emerges as a potential treatment. Post-treatment, patients are expected to demonstrate both subjective and objective amelioration. The technique often requires multiple sessions. The safety profile of BPA is comparable to that of open surgical PEA. Further research is imperative to comprehensively evaluate the long-term efficacy and safety of this therapeutic modality.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Glucocorticoid-induced adrenal insufficiency].
Lakartidningen Pub Date : 2025-02-10
Marcus Imamovic, Per Dahlqvist, Oskar Ragnarsson, Margret Einarsdottir
{"title":"[Glucocorticoid-induced adrenal insufficiency].","authors":"Marcus Imamovic, Per Dahlqvist, Oskar Ragnarsson, Margret Einarsdottir","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Glucocorticoid-induced adrenal insufficiency is an underdiagnosed condition that possibly contributes to increased mortality. Consensus regarding management of glucocorticoid-induced adrenal insufficiency in patients receiving glucocorticoid therapy has previously been lacking, but the European Society of Endocrinology and the Endocrine Society have recently published joint international guidelines on the diagnosis and treatment, summarized in this article. To further support patients and healthcare professionals, and to prevent a potentially fatal adrenal crisis, a national blue corticosteroid treatment card has been introduced. The card is intended to be provided to patients treated with prednisolone >5 mg daily (or equivalent) for >3-4 weeks.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Mild intellectual disability in children - some key considerations].
Lakartidningen Pub Date : 2025-02-05
Elisabeth Fernell, Ida Lindblad, Eva Nordin-Olson, Joachim Sandberg, Anna-Karin Söderström, Eva Tideman, Helka Widengren
{"title":"[Mild intellectual disability in children - some key considerations].","authors":"Elisabeth Fernell, Ida Lindblad, Eva Nordin-Olson, Joachim Sandberg, Anna-Karin Söderström, Eva Tideman, Helka Widengren","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diagnosing mild intellectual disability (ID) in children is very often challenging and may require multiple assessments over time to confirm the diagnosis with confidence. In Sweden, this diagnosis is typically made within the school health services, where close collaboration between psychologists, school doctors, and educators is essential. Children diagnosed with mild ID are entitled to attend specially adapted schools. It is important to recognise that many children with mild ID also experience other developmental, neurological, or neuropsychiatric conditions (ESSENCE). Beyond the initial evaluation in school health services, it is crucial that children be referred to specialised paediatric clinics for further investigation of potential underlying causes. In some cases, a child psychiatry consultation may also be necessary. Given the frequent presence of comorbidities, children with mild ID require ongoing clinical follow-up to support their development over time.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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