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[Lost in translation - the role of medical certificates in Swedish asylum decisions]. [迷失在翻译中——医疗证明在瑞典庇护决定中的作用]。
Lakartidningen Pub Date : 2025-09-12
Anna Sarkadi, Linda Pfister, Rebecca Thorburn Stern
{"title":"[Lost in translation - the role of medical certificates in Swedish asylum decisions].","authors":"Anna Sarkadi, Linda Pfister, Rebecca Thorburn Stern","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Medical certificates for the Swedish Migration Agency are vital documents to prove injuries or illnesses claimed in the asylum process. Our purpose is to provide guidance on the legal bases for the use of medical evidence in the asylum process. To illustrate, we give examples from our study of 74 decisions with medical certificates. Cases were identified from a random sample of 500 files from 590 000 asylum decisions made by the Swedish Migration Agency 2006-2022. Medical certificates were not unanimously taken into account in decisions. For high evidentiary value, the certificates should demonstrate the physician's competence, be based on verifiable sources and include a detailed prognosis and the effects of not receiving adequate treatment. Importantly, certificates can also be used to undermine the patient's trustworthiness if the certificate fails to prove or contradicts claims made by the applicant.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040629","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
[Infections with cardiac implantable electronic device]. [心脏植入式电子设备感染]。
Lakartidningen Pub Date : 2025-09-12
Ava Azari, Ingibjörg Kristjánsdóttir, Paolo Gatti, Andreas Berge, Fredrik Gadler
{"title":"[Infections with cardiac implantable electronic device].","authors":"Ava Azari, Ingibjörg Kristjánsdóttir, Paolo Gatti, Andreas Berge, Fredrik Gadler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Lead extraction is safe and effective in patients with systemic and local infections with a cardiac implantable electronic device. 30-day mortality and 1-year mortality rates were 2.5% and 9.9%, respectively. Systemic infection and chronic kidney disease were independently associated with 30-day and 1-year mortality. Clinical frailty scale 5-7 correlated independently with 1-year mortality. These risk factors should be considered during pre-procedure risk stratification.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040717","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
[Do socioeconomic factors influence treatment choice for thoracic and lumbar spinal fractures?] 社会经济因素会影响胸腰椎骨折的治疗选择吗？］
Lakartidningen Pub Date : 2025-09-03
Ewa Wojcicka, Nikos Schizas, Paul Gerdhem, Simon Blixt
{"title":"[Do socioeconomic factors influence treatment choice for thoracic and lumbar spinal fractures?]","authors":"Ewa Wojcicka, Nikos Schizas, Paul Gerdhem, Simon Blixt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Thoracic and lumbar fractures are common injuries that can be treated either surgically or non-surgically. This study investigated if socioeconomic and demographic factors influence treatment choices in Sweden using data from the Swedish Fracture Register and other national health registers. Results showed no significant association between socioeconomic factors and treatment choices. However, patients age 50-69 years were less likely to undergo surgery, probably because of factors such as osteoporosis and increased comorbidity. The study suggests that Swedish healthcare primarily bases treatment decisions on medical factors rather than socioeconomic background. This contrasts with findings from other countries where healthcare is more influenced by socioeconomic factors.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033701","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
[Vertebral fractures and socioeconomic status]. [椎体骨折与社会经济地位]。
Lakartidningen Pub Date : 2025-09-03
Freyr Gauti Sigmundsson
{"title":"[Vertebral fractures and socioeconomic status].","authors":"Freyr Gauti Sigmundsson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Spinal fractures are common, and distinct epidemiological patterns are well-known.In the young to middle age, high energy trauma is the most common etiology, and men are more afflicted than women. In the geriatric population, osteoporotic vertebral fractures are common, and in this age category the women are most often affected. As vertebral fractures affect all socioeconomic groups in the society, the question arises if treatment of vertebral fractures differs according to the patient's socioeconomic status. A recent Swedish study from Uppsala, using national databases, confirmed the results from previous epidemiological studies and showed that socioeconomic factors do not influence how patients with vertebral fractures are treated in Swedish hospitals.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033650","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
Ny era för svenska läkarprogram.
Lakartidningen Pub Date : 2025-09-03
Magnus Hultin
{"title":"Ny era för svenska läkarprogram.","authors":"Magnus Hultin","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023604","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
[Poisonings with antidepressants]. [抗抑郁药中毒]。
Lakartidningen Pub Date : 2025-09-02
Johan Hallengren, Erik Lindeman, Carl Söderberg, Anna K Jönsson, Lena Thunander Sundbom, Johanna Nordmark Grass
{"title":"[Poisonings with antidepressants].","authors":"Johan Hallengren, Erik Lindeman, Carl Söderberg, Anna K Jönsson, Lena Thunander Sundbom, Johanna Nordmark Grass","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 2019 the Swedish Poisons Information Centre (SPIC) was contacted in 1 198 hospital cases of intentional poisonings with antidepressants. Severe poisonings identified using the Poison Severity Score were divided by the number of prescriptions for the respective antidepressant per 1 000 inhabitants, yielding a substance specific poisoning severity index (PSI). Amitriptyline, clomipramine, venlafaxine and bupropion had PSIs surpassing all other antidepressants by nearly an order of magnitude and comprised almost 80% of 101 serious poisonings. The same substances also scored very high in a suicide mortality index calculated by dividing the 81 antidepressant suicide deaths identified by the National Board of Forensic Medicine (NBFM) in 2019 by prescription rates. Both the SPIC and the NBFM cohorts demonstrate that the risk of severe toxicity from overdose is not uniform among antidepressants. The toxicity profile of the respective substance needs to be considered when antidepressants are prescribed.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959348","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
[To taper or not to taper opioids - that is the question]. [减少或不减少阿片类药物——这是一个问题]。
Lakartidningen Pub Date : 2025-08-20
Emmanuel Bäckryd, Paulin Andréll, Marcelo Rivano Fischer, Cecilia Grinsvall, Anders Håkansson, Thomas F Kallman, Patrik Midlöv, Åsa Ringqvist, Henrik Grelz
{"title":"[To taper or not to taper opioids - that is the question].","authors":"Emmanuel Bäckryd, Paulin Andréll, Marcelo Rivano Fischer, Cecilia Grinsvall, Anders Håkansson, Thomas F Kallman, Patrik Midlöv, Åsa Ringqvist, Henrik Grelz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There is a lack of evidence for long-term opioid treatment of chronic non-cancer pain. According to European guidelines, opioids should not be used for primary chronic pains.  It is important to continuously assess the benefits and harms of each opioid treatment and, if indicated, discontinue it as early as possible to prevent an adverse trajectory. Long-term opioid treatment is a clinically complex situation in which the issue of tapering (deprescribing) should be considered. Tapering is a medical intervention that entails planned support and close follow-up. Potential benefits include increased safety, reversal of side effects, and an improved overall situation. Risks include acute and protracted withdrawal symptoms (including worsening pain) and impaired mental health. Problematic use of opioids (including opioid use disorder) occurs in this population, but prescribers should avoid a stereotypical and stigmatizing attitude.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959454","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
[Early diagnosis of neurodevelopmental disorders (NDD)]. [早期诊断神经发育障碍（NDD）]。
Lakartidningen Pub Date : 2025-08-19
Håkan Odeberg, Pernilla Ackermark, Ulf Andersson, Carina van Geijt, Kent Jonsson, Björn Mårtensson
{"title":"[Early diagnosis of neurodevelopmental disorders (NDD)].","authors":"Håkan Odeberg, Pernilla Ackermark, Ulf Andersson, Carina van Geijt, Kent Jonsson, Björn Mårtensson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Comorbidity between NDD and chronic pain is common. For some pain patients, the NDD has not yet been diagnosed. Referral for diagnosis may interrupt and delay pain rehabilitation, which suggests that integration of such assessment could be beneficial. In 2022-2023 the Regional Pain Rehabilitation unit of Nyköping ran a project in which an external psychologist performed diagnostic assessments, together with the unit's psychiatrist, of 20 patients with a suspected diagnosis of NDD. Nine patients were diagnosed with autism spectrum disorders and 10 with ADD/ADHD. At follow-up, a majority of these patients reported significantly improved overall health and well-being. For these patients, what dominated the clinical picture were the secondary consequences of their underlying developmental disorders, and the energy expended to compensate for them. How to address the needs of these patients is an important field of research.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873820","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
Fenomenet klonal hematopoes av obestämd potential (CHIP).
Lakartidningen Pub Date : 2025-08-18
Johanna Ungerstedt
{"title":"Fenomenet klonal hematopoes av obestämd potential (CHIP).","authors":"Johanna Ungerstedt","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873821","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
[An increase in reported cases of tularemia in Region Stockholm]. [斯德哥尔摩地区报告的兔热病病例增加]。
Lakartidningen Pub Date : 2025-08-12
Lana Othman, Joanna Nederby Öhd, Charlotta Rydgård, Hedvig Glans
{"title":"[An increase in reported cases of tularemia in Region Stockholm].","authors":"Lana Othman, Joanna Nederby Öhd, Charlotta Rydgård, Hedvig Glans","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tularemia is a zoonotic disease caused by the contagious bacterium Francisella tularensis. In Sweden, the infection is primarily transmitted through mosquito bites with peak season from August to October. Depending on the infection site, tularemia has six different clinical variants. Patients are often presented with the ulceroglandular form - fever, inoculation site ulcer and regional lymphadenopathy - but oculoglandular, glandular, oropharyngeal, pneumonic and typhoidal forms also occur. Historically endemic to northern Sweden, tularemia has spread further south since the first case was described in 1931. Due to clinical diversity and sometime prolonged course, the awareness of tularemia  is important for multiple medical specialties. The diagnosis should be considered among patients with typical symptoms in Sweden during peak season.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821958","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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