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[Is occupational allergic contact dermatitis within the armed forces an unrecognized problem?] [武装部队中的职业性过敏接触性皮炎是否是一个未被发现的问题？］
Lakartidningen Pub Date : 2024-06-19
Cecilia Svedman, Kajsa Källberg, Nils Hamnerius, Ulla Wikström
{"title":"[Is occupational allergic contact dermatitis within the armed forces an unrecognized problem?]","authors":"Cecilia Svedman, Kajsa Källberg, Nils Hamnerius, Ulla Wikström","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the armed forces, marching still remains a major component in the training of the young recruits. In the following we describe a young recruit who, following instructions, prophylactically used adhesives to prevent chafing. The recruit developed an allergic contact dermatitis with generalized spreading. The adhesive products recommended are sold on a global market and are extensively used.  Allergic contact dermatitis from these products have so far only been reported from Sweden. Unfortunately, even though the first cases were reported some years ago, new cases are still diagnosed. When medical devices are recommended to be used on the skin for a prolonged time and under extreme conditions, sensitization and a subsequent allergic contact dermatitis must be considered.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419667","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
[Registration and reporting of results from clinical trials in Nordic countries - there is scope for improvement]. [北欧国家临床试验结果的登记和报告 - 仍有改进余地]。
Lakartidningen Pub Date : 2024-06-18
Cathrine Axfors, Gustav Nilsonne
{"title":"[Registration and reporting of results from clinical trials in Nordic countries - there is scope for improvement].","authors":"Cathrine Axfors, Gustav Nilsonne","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Reporting of results from clinical trials is necessary for reliable evidence in clinical decision making, and is mandated as an ethical and regulatory obligation. We have recently followed up reporting of clinical trials in the Nordic countries sponsored by medical universities and university hospitals. Of 2113 studies registered on the EU Clinical Trials Registry (EUCTR) or on clinicaltrials.gov and completed 2016-2019, about half reported results in any form after 24 months and more than one in five did not report results at all. For trials registered on clinicaltrials.gov, about half were prospectively registered. These results are consistent with results from follow-up of registered trials in other contexts and demonstrate that there is scope for improvement in registration and reporting of clinical trials. We urge public sector trial sponsors to enhance their support to trialists in order to ensure that trials are reported in a timely manner.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419668","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
Nya rekommendationer för infusion av betalaktamantibiotika. 关于输注β-内酰胺类抗生素的新建议。
Lakartidningen Pub Date : 2024-06-18
Tove Gustafsson, Erik Eliasson, Mia Furebring, Elisabet Nielsen, Johan Petersson, Magnus von Seth, Thomas Tängden
{"title":"Nya rekommendationer för infusion av betalaktamantibiotika.","authors":"Tove Gustafsson, Erik Eliasson, Mia Furebring, Elisabet Nielsen, Johan Petersson, Magnus von Seth, Thomas Tängden","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419730","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 ambulatory endocrine neck surgery safe?] [门诊颈部内分泌手术安全吗？］
Lakartidningen Pub Date : 2024-06-17
Sara Freidenfelt, Fredrik Karlsson, Catharina Ihre Lundgren
{"title":"[Is ambulatory endocrine neck surgery safe?]","authors":"Sara Freidenfelt, Fredrik Karlsson, Catharina Ihre Lundgren","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This retrospective observational study aimed to identify complications and re-admissions after unilateral exploration of the parathyroid, hemithyroidectomy or resection of the thyroid isthmus in patients that underwent ambulatory surgery at Karolinska University Hospital 2018-2019. The medical records of 280 patients were scrutinized by searching for re-admissions within 10 days or frequent contact with the healthcare provider within 30 days. 256 out of 280 patients underwent ambulatory surgery. 22 patients were converted to inpatient care, one because of postoperative bleeding. Five patients had a complication, one recurrent laryngeal nerve palsy and four postoperative infections. One patient was readmitted within 10 days from surgery, not related to the surgery. Our study supports that with adequate selection of patients and postoperative monitoring, ambulatory endocrine neck surgery can be performed without jeopardizing patient safety.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419666","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
[Risk factors among children born at the limit of viability 22+0 - 23+6 weeks]. [存活极限为 22+0 - 23+6 周的新生儿的风险因素]。
Lakartidningen Pub Date : 2024-06-17
Yasemin Christians Son, Maria Moberg, Alexander Rakow, Ylva Vladic Stjernholm
{"title":"[Risk factors among children born at the limit of viability 22+0 - 23+6 weeks].","authors":"Yasemin Christians Son, Maria Moberg, Alexander Rakow, Ylva Vladic Stjernholm","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Despite improved survival of extremely preterm infants born at <28 weeks gestational age (GA) since the 1990s, only few reports on long-term outcomes have been published. The aim of our study was to determine risk factors among mothers and outcomes for their children born at the limit of viability (GA 22 + 0 - 23 + 6 weeks) at the Karolinska university hospital in 2009-19, before and after the introduction of new national interventionist guidelines in 2016. We hypothesized that infant survival, morbidity and cognitive functions at 2 years' corrected age had improved after the new clinical practice. Maternal risk factors were identified, which emphasize the need of standardized follow-up and counseling for women at increased risk of extreme preterm birth. The intrauterine fetal death rates were unchanged. Among births at 22 weeks, the neonatal mortality tended to decrease 96 vs. 76 percent of live births (p = 0,05), and the 2-year survival tended to increase 4 vs 24 percent (p = 0,05). At 23 weeks, the neonatal mortality decreased 56 vs 27 percent of live births (p = 0,01), and the 2-year survival increased 42 vs 64 percent (p = 0,03). In contrast, the morbidity and cognitive disability at 2 years' corrected age were unchanged. Our results were in accordance with previous reports where no substantial improvement in cognitive functions are reported among infants born at GA <24 weeks since the 1990s. They highlight the importance of comprehensive ethical considerations before active interventions at threatening preterm birth < 24 weeks.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419669","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
[SPOR covers 100 percent of publicly run surgical care]. [SPOR 100%覆盖公立外科医疗服务]。
Lakartidningen Pub Date : 2024-06-14
Björn Holmström, Gunnar Enlund, Claes Frostell, Bengt Cederlund
{"title":"[SPOR covers 100 percent of publicly run surgical care].","authors":"Björn Holmström, Gunnar Enlund, Claes Frostell, Bengt Cederlund","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Swedish Perioperative Register (SPOR) - a national quality register - supports automatic data transfer from local medical records to its central database, without the need for further manual input. Covering 100 percent of surgical operations across all publicly run hospitals in Sweden, SPOR data show regional inequality regarding patients' waiting time from the decision to operate until the start of surgery. SPOR data can inform several areas of improvement for perioperative care, such as management of postoperative pain and nausea, increased use of the Checklist for Safe Surgery, and improved logistics. The growing number of online reports downloaded locally suggests increasing use of SPOR data for follow-up and care improvement efforts. Data from many privately run surgical units do not appear in the SPOR due to technical difficulties in reporting.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419729","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
[Guidelines for uniform management of breath-holding spells]. [憋气法术统一管理指南]。
Lakartidningen Pub Date : 2024-06-05
Sanna Hellström Schmidt, Erik A Eklund, Cornelis Jan Pronk
{"title":"[Guidelines for uniform management of breath-holding spells].","authors":"Sanna Hellström Schmidt, Erik A Eklund, Cornelis Jan Pronk","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Witnessing breath-holding spells (BHS) can be distressing and patients with BHS disproportionately consume a substantial amount of health care resources. Common among preschool children, BHS follow a distinct sequence of events. A comprehensive patient history is the primary diagnostic tool. BHS lacked standardized diagnostic criteria and guidelines until our recent Acta Paediatrica publication. Studying 519 BHS cases in Skåne (years 2004-2018), we found overuse of electrocardiograms (ECGs) and electroencephalograms (EEGs), and underuse of blood tests for treatable iron deficiency and anemia, both known BHS contributors. Building upon our cohort analysis, we refined the definition of BHS and introduced a clinical management algorithm. Simulations showed reduced EEG and ECG use and an increase in blood tests. Our guideline not only streamlines diagnostic processes, but also optimizes the allocation of healthcare resources for more effective and targeted interventions.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248169","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
[VT ablation - a technically complex procedure]. [室间隔缺损消融术--技术复杂的手术]。
Lakartidningen Pub Date : 2024-06-04
Finn Åkerström, Nikola Drca, Jonas Schwieler, Malin Ax, Mats Jensen-Urstad, Frieder Braunschweig
{"title":"[VT ablation - a technically complex procedure].","authors":"Finn Åkerström, Nikola Drca, Jonas Schwieler, Malin Ax, Mats Jensen-Urstad, Frieder Braunschweig","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ventricular tachycardia (VT) in patients with structural heart disease is potentially life threatening, and most patients have an indication for an implantable cardioverter-defibrillator (ICD). Catheter ablation is an effective therapeutic strategy to reduce the risk of VT recurrence and subsequent ICD therapies. However, VT ablation is a technically complex procedure with significant risks and should be performed in experienced centers with appropriate resources. While several reports on outcome and procedural risks have been published, there is currently no data from Sweden. In addition to this literature review, we have analyzed VT ablation outcome data from our center. In 2021 and 2022, 68 VT ablations were performed in 60 patients with structural heart disease. After a median follow-up of 20 months, 18 percent had recurrent VT and there were 2 major adverse events (stroke and complete atrioventricular block). Seven patients died from non-arrhythmia related causes during follow-up. A large proportion (68 percent) were subacute procedures which are associated with a higher periprocedural risk. Referral for VT ablation earlier in the course of disease progression may likely further improve outcomes.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237581","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
[Withdrawal of life sustaining treatment in the ICU - different doctors act differently]. [在重症监护室撤销维持生命的治疗--不同的医生有不同的做法]。
Lakartidningen Pub Date : 2024-06-04
Brian Cleaver, Karin Hildebrand, Maria Cronhjort
{"title":"[Withdrawal of life sustaining treatment in the ICU - different doctors act differently].","authors":"Brian Cleaver, Karin Hildebrand, Maria Cronhjort","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Decisions to withdraw life sustaining treatment in the ICU are common, but there is little information about how treatment should be withdrawn. A pilot study showed that doctors withdraw life sustaining treatment in different ways even in identical cases. This variation can cause stress for ICU staff and relatives.  Our study investigated the decisions of doctors working in ICUs in Sweden regarding the withdrawal of life sustaining treatment for two fictitious patients. There was variation in if and how drug treatments should be withdrawn, as well as how ventilatory support should be withdrawn. Less experienced doctors tended to choose to prolong the dying process by weaning, even if it is unclear if that is preferable for the staff or for relatives.  Our study could be used in discussions in ICUs to try to understand how individual doctors make decisions about withdrawing life sustaining treatment.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237585","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
[Saksenaea caused invasive infection in an immunocompetent patient after trauma]. [Saksenaea 在一名免疫功能正常的外伤患者身上引发了侵袭性感染]。
Lakartidningen Pub Date : 2024-06-03
Michael Axenhus, Hans Nåsell, Per-Anton Svensson, Bo-Martin Brangstrup, Christine Stenström
{"title":"[Saksenaea caused invasive infection in an immunocompetent patient after trauma].","authors":"Michael Axenhus, Hans Nåsell, Per-Anton Svensson, Bo-Martin Brangstrup, Christine Stenström","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This text discusses a rare case of soft tissue infection caused by the fungus Saksenaea in a young, immunocompetent woman following an all-terrain vehicle accident abroad. Despite initial treatment, her wound worsened, necessitating multiple surgical revisions and aggressive antifungal therapy with liposomal Amphotericin B. The interdisciplinary collaboration among orthopedic surgeons, infectious disease specialists, and plastic surgeons played a vital role in her successful treatment. Prompt identification of the fungus and immediate intervention were crucial. This case emphasizes the importance of awareness among healthcare providers regarding this rare condition and underscores the significance of early diagnosis and timely surgical and medical interventions for a positive outcome.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200111","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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