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[Dementia in Down syndrome]. [唐氏综合征痴呆症]。
Lakartidningen Pub Date : 2024-09-30
Ann-Charlotte Granholm, Lotta Larsson, Fredrik Öhman, Henrik Zetterberg, Oskar Hansson, Maria Eriksdotter, Silke Kern, Agneta Nordberg
{"title":"[Dementia in Down syndrome].","authors":"Ann-Charlotte Granholm, Lotta Larsson, Fredrik Öhman, Henrik Zetterberg, Oskar Hansson, Maria Eriksdotter, Silke Kern, Agneta Nordberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Individuals with Down syndrome (DS) have increased prevalence of Alzheimer's disease (AD) at an earlier age than the general population. Diagnostic tools that can improve diagnosis and treatment of dementia in DS and differentiate between dementia and intellectual disabilities include cognitive batteries, sensitive plasma assays, and PET imaging for amyloid and tau. Adults with DS should be included in memory clinic assessments and offered appropriate medications available to the general population with dementia. The Swedish dementia registry, SveDem, has added the diagnosis AD due to the genetic overload in DS, providing a national diagnostic registry for those with DS.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361735","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 first Swedish national care program for pediatric chronic pain]. [瑞典首个全国性儿科慢性疼痛护理计划]。
Lakartidningen Pub Date : 2024-09-30
Karin Berg, Ulla Caverius, Gunilla Ekström, Cecilia Grinsvall, Eva Gåve, Malin Lanzinger, Philipp Mittermaier, Ellen Odéus, Rikard Wicksell
{"title":"[The first Swedish national care program for pediatric chronic pain].","authors":"Karin Berg, Ulla Caverius, Gunilla Ekström, Cecilia Grinsvall, Eva Gåve, Malin Lanzinger, Philipp Mittermaier, Ellen Odéus, Rikard Wicksell","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pediatric chronic pain is common and frequently results in reduced wellbeing and functioning. Limited knowledge among health care professionals has motivated a national care program for pediatric chronic pain to increase the standard of care for this group. Emphasizing a biopsychosocial approach, treatment should focus on self-management of pain and distress to increase resilience, functioning and wellbeing. Furthermore, close collaborations between relevant stakeholders, such as families, healthcare, and school, is critical for optimal and sustained effects.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361737","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
[Closure of emergency hospitals - a reemerging issue in Sweden]. [关闭急诊医院--瑞典再次出现的问题]。
Lakartidningen Pub Date : 2024-09-27
Kjell Asplund
{"title":"[Closure of emergency hospitals - a reemerging issue in Sweden].","authors":"Kjell Asplund","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As the finances of health care providers are increasingly strained, discussions about the closure of some of the emergency hospitals in Sweden have reemerged. I have reviewed the 39 closures that have occurred over the last half century. The closures have come in two distinct waves. The first wave, peaking in 1970-74, was driven by staffing problems with concerns about the quality of care. The second, more prolonged wave occurred in 1995-2004, caused by healthcare providers' strained economy. In 2024, the first closure of an emergency hospital since 2010 occurred and the future of several emergency hospitals is being investigated. A low population in the hospital catchment area has been a strong predictor of hospital closure, but the closure has seldom been followed by a marked population drop. Major arguments in the current debate on emergency hospital closures are listed. The process from a first external evaluation to final closure has followed a stereotypic, often dramatic pattern.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361734","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 Seymour fracture - a fracture that easily can be missed]. [西摩骨折--一种容易被忽略的骨折]。
Lakartidningen Pub Date : 2024-09-25
Unni Jirlow, Utkan Aydin
{"title":"[The Seymour fracture - a fracture that easily can be missed].","authors":"Unni Jirlow, Utkan Aydin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Seymour fracture is a pediatric fracture involving the growth plate of the distal phalanx. It is associated with an overlying nail bed injury, and the child often presents with difficulties to extend fully in the distal joint. If not treated properly it can result in infections such as osteomyelitis or lead to deformities and growth disturbances. Since the extent of the damage of the nail bed can range from more obvious crush injuries to small lacerations of the matrix it can easily be missed in the more subtle cases. Early administration of prophylactic antibiotics, reduction of the fracture and repair of the nail bed are necessary for a good prognosis.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361738","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 potential role of the Swedish Intensive Care Registry data for decision-making in intensive care]. [瑞典重症监护登记数据在重症监护决策中的潜在作用]。
Lakartidningen Pub Date : 2024-09-18
Johnny Hillgren, Lars Engerström
{"title":"[The potential role of the Swedish Intensive Care Registry data for decision-making in intensive care].","authors":"Johnny Hillgren, Lars Engerström","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Swedish Intensive Care Registry collects and analyses data regarding intensive care in Sweden. Based on this data an overview can be created regarding available hospital beds and occupancy rates in Swedish intensive care, as well as demographic and clinical characteristics of the patients, and their survival. Through this, identification of patient groups with poorer prognosis is possible, facilitating reflection of the appropriateness of intensive care and invasive procedures that may cause discomfort to the patient.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290336","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
[Priority setting in intensive care from an ethical perspective]. [从伦理角度确定重症监护的优先次序]。
Lakartidningen Pub Date : 2024-09-18
Niklas Juth, Eva Hannerz Schmidtke
{"title":"[Priority setting in intensive care from an ethical perspective].","authors":"Niklas Juth, Eva Hannerz Schmidtke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Priority setting at intensive care units is legally regulated in accordance with the so-called ethical platform, which states that all priorities must be based on three lexically ranked principles: the principle of human dignity (a ban on discrimination, e.g. based on social standing), the principle of needs and solidarity, and the principle of cost-effectiveness. Prioritization for intensive care is particularly difficult as it requires comparisons between widely different patient categories, occurs in acute situations and is fraught with great uncertainty about the prognosis. Sometimes the degree of severity is maximal for several patients: without treatment, they die. Then treatment effect and cost-effectiveness become more decisive for prioritization decisions. Moreover, withholding and withdrawing intensive care are increasingly considered as morally equivalent. Difficult priority decisions risk moral stress among the intensive care staff.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290335","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
[Intensive care and priority setting during catastrophe or war]. [灾难或战争期间的重症监护和确定优先事项]。
Lakartidningen Pub Date : 2024-09-17
Lars Sandman, Erik Gustavsson
{"title":"[Intensive care and priority setting during catastrophe or war].","authors":"Lars Sandman, Erik Gustavsson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this article we discuss some ethically and legally controversial issues in the Swedish priority guidelines for intensive care during the recent covid pandemic. We show how the Swedish ethics platform for priority setting constitutes a robust starting point for such guidance, but that there is a lack of detail leaving some of the more challenging situations without explicit guidance. To provide guidance, which we have reason to do in order to avoid inequality and arbitrariness, we should try to interpret the ethics platform, based on how it is applied in practice together with ethical reasoning. In this article, we illustrate this by focusing on contested guidance concerning biological age when distributing scarce intensive care beds. We conclude that biological age should be interpreted in terms of long-term survival. We also conclude that the ethical platform does not provide guidance in these challenging situations, but needs interpretation. Therefore, there is a need of a legal overview of the principles in order to create an even stronger basis for support in the future.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290334","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
[How Region Sörmland dealt with Covid-19 in 2020-2021]. [2020-2021 年萨尔姆兰地区如何应对 Covid-19]。
Lakartidningen Pub Date : 2024-09-17
Markus Castegren
{"title":"[How Region Sörmland dealt with Covid-19 in 2020-2021].","authors":"Markus Castegren","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In Region Sörmland, the burden of critical illness during the first wave of Covid-19 in april 2020 lead to a 25-fold increase in the number of patients requiring invasive mechanical ventilation. The decision was made that quantity should be prioritised before individual quality. This led to a highly standardised care during the intensive care period. All patients admitted to any of the county's three hospitals were assessed as regarded their ability to survive invasive mechanical ventilation. The assessment was based on the Charlson Age-adjusted Comorbidity Index and the Clinical Frailty Scale. Of all >2000 admitted patients with Covid-19, 37% were assessed as not to benifit from mechanical ventilation. The outcome of intensive care patients was very good in Region Sörmland compared to the rest of Sweden, with a 30-day mortality rate of 14% following intensive care. The outcome after Covid-19-associated intensive care in Sweden differed highly between ICUs, with a span of 7-58% 30-day mortality rate.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290333","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
Gränsvärden för riskbruk av alkohol bör individanpassas. 对危险饮酒的限制应因人而异。
Lakartidningen Pub Date : 2024-09-12
Anders Helander, Alan Wayne Jones
{"title":"Gränsvärden för riskbruk av alkohol bör individanpassas.","authors":"Anders Helander, Alan Wayne Jones","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290337","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 model of Health dialogues - a systematic review]. [瑞典健康对话模式--系统回顾]。
Lakartidningen Pub Date : 2024-09-04
Margareta Kristenson, Mats Börjesson, Yvonne Forsell, Lars Jerdén
{"title":"[The Swedish model of Health dialogues - a systematic review].","authors":"Margareta Kristenson, Mats Börjesson, Yvonne Forsell, Lars Jerdén","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Lifestyle habits are key determinants for premature death. The Swedish model of health dialogues, which has been developed since 1985, aims to promote a healthy lifestyle by inviting everybody in specific age groups to primary care for health dialogues combined with community-oriented efforts. In the first systematic review of the model, seven studies were identified, all with a control/reference group and follow-up of at least one year. GRADE (Grading of Recommendations, Assessment, Development and Evaluation) was used to assess the quality of evidence. Results showed that the model reduced premature all-cause and cardiovascular mortality (moderate evidence/+++), reduced blood pressure, cholesterol, fasting blood glucose, waist size and BMI (moderate/low evidence) and improved dietary habits (moderate evidence/+++). Health benefits were greater when health dialogues were combined with community-oriented efforts.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126112","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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