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[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
[Peripheral nerve injuries - early diagnosis and appropriate treatment is crucial].
Lakartidningen Pub Date : 2025-02-03
Lars B Dahlin
{"title":"[Peripheral nerve injuries - early diagnosis and appropriate treatment is crucial].","authors":"Lars B Dahlin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ballistic injuries to upper and lower limbs in local and international conflicts are common, where particularly peripheral nerve injuries should be highlighted. Handling of injured and destroyed tissues requires a fast and competent multidisciplinary management of the patient and depends on the extent and character of the injuries. Early experiences from conflicts have shown that peripheral nerve injuries are difficult to treat, often resulting in extensive permanent loss of function, risk for pain problems and life-long reduced quality of life. Early diagnosis, sometimes based on »active surveillance« of the nerve injury, initiation of appropriate surgical techniques from the panel of conventional and novel methods, and pharmacological treatment of nerve injuries are keystones and can improve the situation for the affected patient, where timing of treatment is crucial.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256222","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
[Gene editing is changing the treatment of hereditary diseases].
Lakartidningen Pub Date : 2025-01-29
C I Edvard Smith, Rula Zain, Pontus Blomberg
{"title":"[Gene editing is changing the treatment of hereditary diseases].","authors":"C I Edvard Smith, Rula Zain, Pontus Blomberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Gene editing is a novel technology within gene therapy, which changes sequences in chromosomal DNA with precision. Even if there are alternative strategies, the Nobel Prize-winning CRISPR/Cas technology has become the dominating principle. During recent years base editing and prime editing, permitting editing without DNA double-strand breaks, have been developed. The first clinical gene editing results were reported in 2021; since then many patients have been treated, and recently the first treatment was approved as a novel therapy in the UK and later in USA and in EU. This update describes various aspects including methodological developments and safety.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059783","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
[AmbuReg - the Swedish quality register for emergency medical services].
Lakartidningen Pub Date : 2025-01-29
Glenn Larsson, Johan Herlitz, Christer Axelsson, Maria Hegardt Janson, Susanne Albrecht, Håkan Klementsson
{"title":"[AmbuReg - the Swedish quality register for emergency medical services].","authors":"Glenn Larsson, Johan Herlitz, Christer Axelsson, Maria Hegardt Janson, Susanne Albrecht, Håkan Klementsson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Swedish quality register AmbuReg collects all the country's ambulance missions. There is an increasing demand on the Emergency Medical Services (EMS) due to decreasing hospital resources and referral to self-care, primary care and mobile teams. This, in combination with fast tracks for patients with myocardial infarction, stroke, hip fracture or sepsis, increases the requirement for optimal triage at the scene. The aim of the registry is to ensure the quality and identify limitations in the EMS that may threaten patient safety, such as documentation, assessment, triage and treatment. The development of decision support tools will be required in the future and in collaboration with other national quality registries. Regarding adherence to guidelines for assessment and treatment of symptoms, particularly pain, and the use and analysis of equipment such as ECG and analysis of serum glucose, different quality goals may be set. An example may be that at least 80% of strokes should be recognized at the scene.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059780","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: Aortagraftinfektioner.
Lakartidningen Pub Date : 2025-01-28
Hamid Gavali, Kevin Mani, Mia Furebring, Camilla Lorant, Anders Wanhainen
{"title":"ABC: Aortagraftinfektioner.","authors":"Hamid Gavali, Kevin Mani, Mia Furebring, Camilla Lorant, Anders Wanhainen","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059740","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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