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[Swedish dental care support and organization today - and a future perspective]. [瑞典牙科保健的支持和组织现状--以及未来展望]。
Lakartidningen Pub Date : 2024-03-08
Elisabeth Wärnberg Gerdin, Björn Klinge
{"title":"[Swedish dental care support and organization today - and a future perspective].","authors":"Elisabeth Wärnberg Gerdin, Björn Klinge","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In Sweden, dental care is carried out in regional operations, public dental care (Folktandvården), or in private practice. The patient is free to choose a public or private care provider. Up to and including the age of 23, all dental care is free of charge for the patient. From the age of 24, there is a state dental care subsidy to limit patient costs. There is free pricing in dental care, both for public and private actors. The article describes more in detail how the dental care support is structured in its various parts. Furthermore, the organization of dental care is presented, and a future perspective. A developed collaboration between dental and medical care and other health care seems increasingly obvious.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094349","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
[Health care in Sweden rates high in international comparison]. [瑞典的医疗保健在国际比较中名列前茅]。
Lakartidningen Pub Date : 2024-03-07
Birger Forsberg
{"title":"[Health care in Sweden rates high in international comparison].","authors":"Birger Forsberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Swedish health care rates high in international comparisons of health systems performance. Indicators show that medical outcomes are good and that most patients are satisfied with their reception in the health care services. Waiting times in Sweden are however longer than in many other European countries. Factors behind the good quality of Swedish health care could well be high level of general development, well trained and often highly motivated health staff and well developed support systems for clinical decision making.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140059839","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
[Is individualized education for a medical students desirable?  A common policy on how to handle medical students requests for individual adaptations is needed]. [医学生的个性化教育是否可取？ 需要制定一项共同政策来处理医学生提出的个性化适应要求]。
Lakartidningen Pub Date : 2024-02-28
Jenny Lindberg, Sam Polesie, Marit Karlsson, Erik Malmqvist, Goran Mijaljica
{"title":"[Is individualized education for a medical students desirable?  A common policy on how to handle medical students requests for individual adaptations is needed].","authors":"Jenny Lindberg, Sam Polesie, Marit Karlsson, Erik Malmqvist, Goran Mijaljica","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In Sweden, freedom of conscience for health care professionals is not legally permitted. However, requests from medical students to adjust and/or skip compulsory learning activities because of their religious and moral convictions appear to get more abundant. This creates problems when learning activities are directly related to the examination objectives stated by the Higher Education Ordinance of Sweden. Allowing students to abstain from certain parts of the medical program raises difficulties as to what kind of convictions that should be accepted and to what degree. Questions arise regarding equality of learning opportunities, assessment, and reasonable resource allocation. We call for national debate regarding these issues, which different universities now are forced to handle on their own, with the aim of establishing a common approach.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983275","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
[CBT administered via the internet]. [通过互联网进行的 CBT]。
Lakartidningen Pub Date : 2024-02-27
Martin Kraepelien, Nils Lindefors, Amira Hentati, Dorian Kern, Erik Forsell, Viktor Kaldo, Brjánn Ljótsson
{"title":"[CBT administered via the internet].","authors":"Martin Kraepelien, Nils Lindefors, Amira Hentati, Dorian Kern, Erik Forsell, Viktor Kaldo, Brjánn Ljótsson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cognitive behavioral therapy (CBT) can be administered clinically to individuals and in group settings. More recently, CBT has been administered successfully via the internet (ICBT). We provide a concept aiming at further developing ICBT in a self-care format. We use recent development in user interface (UI) design in order to optimize the user interface and allow easy and flexible use via smartphone, tablet, or computer. Preliminary evidence indicates that an optimized user interface and adjusted information facilitate increased use of training programs compared to a traditional ICBT interface. Our aims are to allow increased availability of evidence-based CBT tools for self-care to improve people's health and recovery from disease. So far, evidence for effects and safe use is indicated for atopic dermatitis, insomnia and high-risk use of alcohol.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972520","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
[Molecular diagnostics enable targeted therapies for anaplastic and poorly differentiated thyroid cancer]. [分子诊断为无性和分化不良甲状腺癌的靶向治疗提供了可能]。
Lakartidningen Pub Date : 2024-02-27
Renske Altena, Mikael Nilsson, Viveka Bergman, Jakob Dahlberg, Carl Christofer Juhlin, Jan Zedenius
{"title":"[Molecular diagnostics enable targeted therapies for anaplastic and poorly differentiated thyroid cancer].","authors":"Renske Altena, Mikael Nilsson, Viveka Bergman, Jakob Dahlberg, Carl Christofer Juhlin, Jan Zedenius","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anaplastic and poorly differentiated thyroid cancer (ATC, PDTC) are rare and highly aggressive tumors that historically have been associated with a short life expectancy and low chance of cure. Molecular pathology and the introduction of highly effective targeted drugs have revolutionized the possibilities of management of patients with ATC and PDTC, with BRAF and MEK inhibitors as the most prominent example. Here we provide updated recommendations regarding diagnostics and management, including primary surgical management and targeted therapies based on specific molecular pathological findings.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858880","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
Låt inte ovaliderade diagnoser få fäste innan evidens finns. 在获得证据之前，不要让未经验证的诊断占据上风。
Lakartidningen Pub Date : 2024-02-23
Mats Adler, Johan Bengtsson, Christian Rück
{"title":"Låt inte ovaliderade diagnoser få fäste innan evidens finns.","authors":"Mats Adler, Johan Bengtsson, Christian Rück","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972521","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
[2.6 million cataract surgeries: 31 years with the Swedish National Cataract Register 1992-2022]. [260万例白内障手术：1992-2022年瑞典全国白内障登记册31年]。
Lakartidningen Pub Date : 2024-02-14
Tomas Bro, Mats Lundström, Maria Kugelberg, Ingela Nilsson, Madeleine Zetterberg, Andreas Viberg, William Thorburn, Ulf Stenevi, Anders Behndig
{"title":"[2.6 million cataract surgeries: 31 years with the Swedish National Cataract Register 1992-2022].","authors":"Tomas Bro, Mats Lundström, Maria Kugelberg, Ingela Nilsson, Madeleine Zetterberg, Andreas Viberg, William Thorburn, Ulf Stenevi, Anders Behndig","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This review summarizes data collected by the Swedish National Cataract Register (NCR), which by the end of 2022 contained data on more than 2.6 million cataract surgeries between 1992-2022. During these 31 years, the cataract surgery rate (CSR) rose from 3 700 to 14 407. The coverage of NCR is very high, including 93% of all cataract procedures in Sweden during the last decade. A clear trend is that the procedure is performed in eyes with increasingly high visual acuity. The proportion of patients with Snellen 0.5 or worse in the first eye at surgery has decreased from 88% in 2007 to 69% in 2022. Patient Reported Outcome Measures (PROM) have been registered with the Catquest-9SF questionnaire since 2008, demonstrating stable favorable outcomes. Surgical complications have decreased; endophthalmitis has decreased from 0.10% to below 0.02%, and posterior capsule rupture from 2.8% to 0.6%.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900192","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
SGLT2-hämmare – bra för hjärta och njurar men tänk på riskerna. SGLT2 抑制剂--对心脏和肾脏有益，但要注意风险。
Lakartidningen Pub Date : 2024-02-13
Karolina Nowinski, Anna Ugarph-Morawski, Peter Bárány, Pontus Curman
{"title":"SGLT2-hämmare – bra för hjärta och njurar men tänk på riskerna.","authors":"Karolina Nowinski, Anna Ugarph-Morawski, Peter Bárány, Pontus Curman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900195","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
[Sodium glucose cotransporter-2 inhibitors (SGLT2i) and risk of ketoacidosis]. [葡萄糖钠共转运体-2 抑制剂（SGLT2i）与酮症酸中毒的风险]。
Lakartidningen Pub Date : 2024-02-13
Lina-Maria Nordvall, Bertil Ekstedt, Jörn Schneede
{"title":"[Sodium glucose cotransporter-2 inhibitors (SGLT2i) and risk of ketoacidosis].","authors":"Lina-Maria Nordvall, Bertil Ekstedt, Jörn Schneede","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>SGLT2i can induce euglycemic diabetic ketoacidosis (eDKA) in conditions with relative insulin deficiency, such as infections, surgery, or fasting state. In comparison with classical DKA, eDKA typically presents with lower blood glucose levels and more diffuse symptoms like tiredness, tachypnea, nausea and abdominal pain. The diagnosis is commonly delayed, and signs are often attributed to other factors. Early diagnosis and prevention are critical due to the risk of lethal outcome or prolonged hospital stay. Generous screening for ketonemia in risk situations allows identification of eDKA. To minimize the risk, we propose that SGLT2i should be discontinued 3-4 days before surgery (1-2 weeks prior to bariatric surgery) and during infections, acute disease, or poor oral intake. Postoperative slow infusion of low-dose insulin may prevent eDKA if SGLT2i could not be stopped in time or in prolonged fasting state. In this overview, the pathogenesis behind eDKA is discussed.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900194","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
[Esophageal-ECG in the emergency department]. [急诊科食道心电图]。
Lakartidningen Pub Date : 2024-02-12
Åslög Hellström Vogel, Eric Dryver, Erik Ljungström, Pyotr Platonov
{"title":"[Esophageal-ECG in the emergency department].","authors":"Åslög Hellström Vogel, Eric Dryver, Erik Ljungström, Pyotr Platonov","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The management of tachycardias depends on their underlying pathophysiology. The key to uncovering this pathophysiology is in finding the temporal relationship between atrial and ventricular activation. The P-waves resulting from atrial activation can however be hard to detect on a traditional EKG in the setting of a tachycardia. Esophageal-EKG can help reveal the P-waves. The patient swallows an electrode, whose position in the esophagus is then adjusted to maximize the signal coming from the left atrium, clearly revealing atrial activity. This article describes the indications and contraindications for esophageal-EKG, as well as how it is performed and interpreted. Esophageal-EKG is of particular diagnostic value in the setting of a regular tachycardia with wide QRS complexes and no obvious signs of atrio-ventricular dissociation. In this setting, the esophageal-EKG can distinguish between ventricular tachycardia and a supraventricular tachycardia with aberrant conduction.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900193","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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