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Primärvården bör återgå till sitt kärnuppdrag – att vårda sjuka. 初级保健应回归其核心使命--照顾病人。
Lakartidningen Pub Date : 2025-04-04
Amanda Niklasson, Hálfdán Pétursson, Minna Johansson
{"title":"Primärvården bör återgå till sitt kärnuppdrag – att vårda sjuka.","authors":"Amanda Niklasson, Hálfdán Pétursson, Minna Johansson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811716","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
[New guidelines for atrial fibrillation]. [房颤新指南]。
Lakartidningen Pub Date : 2025-04-03
Mashroor Khan, Anna Björkenheim, Emma Svennberg
{"title":"[New guidelines for atrial fibrillation].","authors":"Mashroor Khan, Anna Björkenheim, Emma Svennberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Atrial fibrillation is a chronic and complex condition. The new 2024 European Society of Cardiology guidelines emphasize a holistic approach to managing atrial fibrillation, introducing the AF-CARE framework. The guidelines prioritize addressing (C) Comorbidities and risk factors for all patients, irrespective of their thromboembolic risk or symptoms. This is followed by strategies to (A) Avoid stroke and thromboembolism, and to (R) Reduce symptoms through rate and rhythm control, potentially improving prognosis. Finally, (E) Evaluation and reassessment should be individualized, with a dynamic approach that adapts to changes in the patient's condition over time.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811712","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
[Choosing Wisely concepts should be introduced to medical students at medical schools in Sweden]. [应向瑞典医学院的医学生介绍明智选择的概念]。
Lakartidningen Pub Date : 2025-04-03
Ulf Bergsten, Martin Almquist
{"title":"[Choosing Wisely concepts should be introduced to medical students at medical schools in Sweden].","authors":"Ulf Bergsten, Martin Almquist","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Choosing Wisely (CW) is an international campaign aiming to reduce low-value care, care without patient benefit. Despite increasing costs in health care, low-value care is a widespread phenomenon. The Swedish Society of Medicine has recently launched CW in Sweden.  Other countries have introduced the concept in medical schools. In the present project, we wanted to investigate whether this could be done in Sweden. We interviewed representatives from medical schools in Canada, Norway, and Sweden, to learn how CW was introduced and integrated in medical education in other countries and to examine the knowledge and attitudes about CW among Swedish medical school faculty, to understand how and if CW could be integrated into the Swedish medical curriculum. We found three ways of implementing CW into a medical curriculum: by letting medical students identify teaching activities, such as case discussions, seminars, and lectures, where CW could be integrated (\"bottom-up\"), by letting program boards change curricula (\"top-down\"), or by letting medical students work with specific de-implementation projects as part of their scientific projects (\"de-implementation lists\").  We also found that faculty at Swedish medical schools are aware of CW to a varying degree, but they agree that reducing low-value care is important and that CW could be implemented already in medical school, perhaps by integrating CW into so-called entrustable professional activities, EPA.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811711","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
I väntan på bra väntetidsdata för kataraktoperation.
Lakartidningen Pub Date : 2025-04-01
Tomas Bro, Madeleine Zetterberg, Andreas Viberg
{"title":"I väntan på bra väntetidsdata för kataraktoperation.","authors":"Tomas Bro, Madeleine Zetterberg, Andreas Viberg","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764305","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
[Acute replantation after facial amputation injuries]. [面部截肢损伤后急性再植]。
Lakartidningen Pub Date : 2025-03-26
Stina Rittri, Alexander Larsson, Jens Larsson, Martin Halle
{"title":"[Acute replantation after facial amputation injuries].","authors":"Stina Rittri, Alexander Larsson, Jens Larsson, Martin Halle","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Amputation injuries to the face and scalp, although uncommon, can have devastating consequences. Microvascular replantation of the amputated tissue in the facial or scalp region often yields the best functional and aesthetic outcomes. It is crucial to promptly assess amputation injuries and contact a reconstructive plastic surgery service to discuss the possibility of microvascular replantation. While awaiting surgery, the amputated tissue should be wrapped in moist gauze, placed in a sealed plastic bag, and stored in an ice water bath or a refrigerator. In the literature, the success rate for microvascular replantation of the face and scalp exceeds 70% for urgent replantations. Notably, successful replantation has been reported even after extended cold ischemia times. However, it is essential to recognize that longer ischemic times are associated with an increased risk of replantation failure.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764300","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 Handläggning av psykiska besvär.
Lakartidningen Pub Date : 2025-03-25
Christian Nordenstam, Johan Bengtsson, Kristoffer Domargård, Katrin Hagskog Engel
{"title":"ABC om Handläggning av psykiska besvär.","authors":"Christian Nordenstam, Johan Bengtsson, Kristoffer Domargård, Katrin Hagskog Engel","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719604","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
[Pan-neurofascin autoimmune nodopathy - an emerging and treatable differential diagnosis to Guillain-Barré syndrome]. 泛神经束蛋白自身免疫性结节病——格林-巴罗综合征的一种新出现且可治疗的鉴别诊断。
Lakartidningen Pub Date : 2025-03-24
Ivan Kmezic, Anders Eriksson, Eva Sundman, Rayomand Press
{"title":"[Pan-neurofascin autoimmune nodopathy - an emerging and treatable differential diagnosis to Guillain-Barré syndrome].","authors":"Ivan Kmezic, Anders Eriksson, Eva Sundman, Rayomand Press","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Autoimmune nodopathy (AN) is an emerging diagnostic category with antibodies targeting the peripheral node of Ranvier. Clinically, AN overlaps with Guillain-Barré syndrome (GBS) and acute-onset CIDP. However, the immunopathology of AN is different, hence AN is considered as a separate entity. Antibodies targeting all neurofascin isoforms are associated with a phenotype and immunopathology described as pan-neurofascin (panNF) AN. Here, we describe a clinical and serological work-up of two patients with anti-panNF IgG4 AN, as well as treatment response. Due to the high morbidity of panNF and its treatable nature, we suggest early antibody testing in severe cases of GBS, especially when a prolonged need for invasive ventilation occurs. Specialized intensive care rehabilitation promotes autonomy and recovery, and should be considered as an alternative to traditional ICU care.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710537","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
[Non-seminomatous testicular cancer presenting with hyperthyroidism]. [以甲亢为表现的非半瘤性睾丸癌]。
Lakartidningen Pub Date : 2025-03-24
Djordje Grujovic, Åke Sjöholm
{"title":"[Non-seminomatous testicular cancer presenting with hyperthyroidism].","authors":"Djordje Grujovic, Åke Sjöholm","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Thyrotoxicosis caused by human chorionic gonadotropin (hCG) is a rare form of hyperthyroidism, often associated with conditions involving very high levels of hCG and sometimes seen in women with gestational hyperthyroidism. Here we present a case of a 53-year-old man with metastatic non-seminomatous testicular cancer (NSGCT) and concomitant thyrotoxicosis related to extremely high hCG levels. The patient sought care with symptoms such as fatigue, weight loss, nausea, and a distended abdomen. Laboratory work-ups showed thyrotoxicosis with suppressed TSH and elevated levels of free T4 and T3. At the same time, a grossly elevated hCG level of over 100,000 IU/L was detected. Further diagnostics confirmed NSGCT with extensive liver, lung, and lymph node metastases. The patient was treated with chemotherapy, which resulted in rapid reduction of hCG levels and remission of thyrotoxicosis. Thyrotoxicosis induced by hCG should be considered in patients with germ cell tumors and very high hCG levels. Effective treatment of the underlying malignancy can lead to normalization of the thyroid function.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710536","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
[Increasing prescription of drug treatment for sleep disorders in children calls for reflection]. [增加儿童睡眠障碍的药物治疗处方需要反思]。
Lakartidningen Pub Date : 2025-03-21
Kjersti Kvernebo Sunnergren
{"title":"[Increasing prescription of drug treatment for sleep disorders in children calls for reflection].","authors":"Kjersti Kvernebo Sunnergren","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sleep disorders are common in children. The Swedish Medical Products Agency recommends careful evaluation of children with sleep disorders with focus on underlying disease and lifestyle factors. The treatment of choice is implementation of sleep hygiene advice. Medical treatment is rarely necessary. The endogenous melatonin level is affected by lifestyle factors such as exposure to darkness and blue light at nighttime. Addressing lifestyle factors is necessary to secure an effective treatment. Within child and adolescent psychiatry, there is a trend of increasing prescription of drug treatment for various diagnoses, including sleep disorders. Caregivers may express a desire to find an easy solution to a complex problem, but extensive prescription of melatonin should be avoided. Melatonin has physiological effects exceeding regulation of sleep. The potential long-term effects of melatonin treatment are not known. Children are vulnerable and should be treated with extra caution.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710534","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 use of melatonin continues to increase - rational prescribing and follow-up is important]. [褪黑素的使用继续增加-合理的处方和随访是重要的]。
Lakartidningen Pub Date : 2025-03-21
Elin Dahlén, Emelie Bergman Perland, Elin Maria Bergsten, Veronica Arthurson, Elin Kimland
{"title":"[The use of melatonin continues to increase - rational prescribing and follow-up is important].","authors":"Elin Dahlén, Emelie Bergman Perland, Elin Maria Bergsten, Veronica Arthurson, Elin Kimland","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The prescribing of melatonin continues to increase and occurs partially off-label. The largest increase is among children aged 6-17 years. During the COVID pandemic, the over-the-counter sales of melatonin increased despite jet lag in adults being the only approved indication. The Swedish Medical Products Agency notes an increased interest in melatonin and signals of unwarranted sale of melatonin as a dietary supplement. There is a risk that melatonin medications are used too casually. In addition, knowledge of the long-term effects of melatonin use is scarce. The increasing use of melatonin needs to be highlighted and monitored to ensure rational use.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710538","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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