Niklas Marklund, Yelverton Tegner, Victor Bull, Kajsa Johansson, Lars Lundgren, Mikael Swarén, Henrik Zetterberg, Tönu Saartok
{"title":"[Management of sports-related concussion - a stepwise rehabilitation protocol].","authors":"Niklas Marklund, Yelverton Tegner, Victor Bull, Kajsa Johansson, Lars Lundgren, Mikael Swarén, Henrik Zetterberg, Tönu Saartok","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Early recognition and management of sports-related concussion (SRC), including removal from the sports activity, is essential for player safety and to prevent long-term symptoms. A graduated, stepwise rehabilitation protocol is implemented to allow the athlete to return to sports. In 2022, the 6th international consensus statement on concussion in sports was presented, which has now been adapted to Swedish conditions. In the present overview, the updated recommendations for SRC in athletes are summarized.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275290","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}
Göran Dellgren, Oscar Braun, Erik Björklund, Emil Najjar, Erik Tossavainen, Henriette van der Wal, Barna Szabo-Söderberg, Kristjan Karason
{"title":"Permanent vänsterkammarpump som behandling vid svår hjärtsvikt.","authors":"Göran Dellgren, Oscar Braun, Erik Björklund, Emil Najjar, Erik Tossavainen, Henriette van der Wal, Barna Szabo-Söderberg, Kristjan Karason","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258380","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}
{"title":"[Dementia with Lewy bodies in Sweden: diagnosis, treatment, challenges, and support].","authors":"Daniel Ferreira, Anna Rennie, Elisabet Londos","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia. While its prevalence is commonly reported to be 5% of all dementia cases, DLB is severely under-diagnosed and under-recognized, with prevalence rates reported to be up to 25% in some studies. This article strives to increase social and professional awareness of DLB in Sweden, under the auspice of the Swedish Lewy Body Network. The article summarizes the key clinical and biological characteristics of DLB, including its prodromal stages. We discuss current challenges and provide practical recommendations to improve health care in DLB in Sweden. Treatment opportunities that modify the disease are lacking, while this article suggests several opportunities for symptomatic treatment that often improve the quality of life of people with DLB.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248536","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}
Lova Tralla, Sara Gustavsson, Anders Sundström, Lena Thunander Sundbom, Fredrik Kugelberg
{"title":"[Prescribed drugs are used in suicides by drug poisoning].","authors":"Lova Tralla, Sara Gustavsson, Anders Sundström, Lena Thunander Sundbom, Fredrik Kugelberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 2019, 829 people died from drug poisoning according to the National Board of Forensic Medicine's database, of which 269 (32 percent) were assessed as suicide, 354 (43 percent) as unintentional poisonings and 206 (25 percent) as poisonings of undetermined intent. The proportion of the deceased that had a filled prescription (within one year preceding the death) for the substance that contributed to the death varied considerable between substances. The highest proportion of fatalities with a dispensed prescription was seen in intoxications with propiomazine (88 percent), zopiclone (85 percent) and alimemazine (84 percent). A filled prescription was very common amongst suicides, but less common amongst unintentional poisonings. When put in relation to sales of pharmaceuticals affecting the nervous system (ATC code N) in Sweden, however, the number of fatalities is low.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208917","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}
{"title":"[Shift workers and the circadian rhythms].","authors":"Maria Lennernäs, Cornelia Wulff Hamrin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Disruptions to our biological clock can lead to metabolic consequences. Shift workers are therefore predisposed to chronic diseases. Chronobiology refers to the rhythms of bodily functions, being controlled by clock genes. These inherent circadian rhythms are synchronized to a 24-hour period by daylight and behavior. Chrononutrition emphasizes the importance of timing eating for optimal health. While circadian variations in response to food were observed decades ago, there is now a renewed interest in this area. It is recommended to have breakfast, to maintain regular times for eating during the day and to avoid night eating. In the workplace, promoting healthy eating habits involves providing meal breaks, optimizing the physical meal environment, and providing guidance on mealtimes for both work hours and leisure time. Further systematic studies are needed to fully understand the impact of chrononutrition on overall health. Nordic Nutrition Recommendations do not include meal patterns.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199463","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}
{"title":"[Acute kidney injury - prevention and treatment].","authors":"Max Bell, Carl M Öberg, Marcus Ewert Broman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute kidney injury is a heterogeneous multifactorial syndrome. Despite the existence of new biomarkers, changes in creatinine level or diuresis - both measures of kidney function - are still used to rate kidney injury. The kidney has several other functions, such as regulation of fluid balance, electrolyte balance, and hemodynamics. In addition, the kidney is endocrinologically active and secretes, among other things, renin and erythropoietin. All functions of the kidney can be impaired. Acute kidney injury is significantly associated with increased morbidity and mortality. Acute kidney injury often occurs secondarily to other diseases or organ failures. When encountering a patient with acute kidney injury in outpatient care, one must first assess whether life-threatening conditions such as hyperkalemia, severe metabolic acidosis, and fluid accumulation exist and, if so, promptly refer the patient to the emergency department. If there are no immediately life-threatening conditions, factors that can reverse kidney failure should be identified. If this is not successful, the patient should be referred to a nephrologist. Acute kidney injury in critically ill patients is often linked to other severe multi-organ failures. AKI should be carefully monitored and the kidneys should be protected as much as possible, and if kidney function deteriorates, renal replacement therapy should be initiated.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150977","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}
Thomas Lindow, Olle Pahlm, Arash Mokhtari, Sasha Koul, Peter Hammarlund, Ulf Ekelund
{"title":"[»Occlusion Myocardial Infarction« (OMI) - a new classification proposed to improve detection beyond strict STEMI criteria].","authors":"Thomas Lindow, Olle Pahlm, Arash Mokhtari, Sasha Koul, Peter Hammarlund, Ulf Ekelund","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The classification of acute myocardial infarction (AMI) based on ECG changes has evolved over time. Before the revascularization era, AMI was classified based on Q-waves that indicate loss of myocardium. After thrombolysis trials in the 1990s demonstrated a survival benefit, ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) classifications were introduced to guide immediate reperfusion therapy with thrombolysis or percutaneous coronary intervention. However, STEMI criteria have limitations. ST elevation is not synonymous with acute coronary occlusion and can occur in pericarditis, early repolarization, left ventricular hypertrophy and other disorders. The process of occlusion is dynamic, and temporary thrombus resolution may cause ST elevation to be absent at the time of ECG recording. Furthermore, ST elevation depends on vector orientation; posterior infarcts may only show ST depression. Studies show that many NSTEMI cases are caused by acute occlusions, which are associated with worse prognosis. The sensitivity of current STEMI criteria is low, and several ECG findings suggestive of acute coronary occlusion have been described. A new classification, »Occlusion Myocardial Infarction« (OMI), has been proposed to improve detection and guide intervention beyond strict STEMI criteria.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150975","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}
{"title":"Astma – en prövning för vården.","authors":"Christer Janson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120216","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}
Oksana Tenselius, Sara Barsch-Cornacchini, Valentyna Yasinska
{"title":"[Severe asthma and biological therapies].","authors":"Oksana Tenselius, Sara Barsch-Cornacchini, Valentyna Yasinska","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Severe asthma is a relatively common, chronic, heterogeneous inflammatory disease affecting around 4-10% of all asthmatics. Most of these have uncontrolled eosinophilic asthma, the treatment of which accounts for >50% of healthcare costs attributed to the disease. Management of severe asthma requires a thorough investigation to exclude comorbidities and determine the underlying type of inflammation and resulting asthma phenotype, so that suitable treatments can be chosen. Systematic assessment and evaluation of treatment must then be performed every 3-6 months. Severe asthma is mostly driven by type 2 inflammation, and we now have several specific biological therapies targeting this inflammation, yet some patients remain poorly controlled due to the heterogenous nature of this disease with its many sub-phenotypes. Therefore, research must determine which clinical and patient reported outcomes as well as biomarkers best reflect response to therapy and thus should be monitored in the clinic.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078920","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}
{"title":"[The immunopathology of asthma].","authors":"Jenny Mjösberg, Johanna Emgård","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Type 2 (T2) high asthma, characterized by T2 markers such as eosinophilia, is driven by type 2 innate lymphoid cells (ILC2) and allergen-activated T helper (Th2) cells. Epithelial-derived cytokines called alarmins, IL-33, TSLP, IL-25 and TL1A, acting on dendritic cells and ILC2, are key in driving both allergic and non-allergic T2 high asthma. Alarmins are produced in response to allergens, pathogens, pollutants etc. Cytokines produced by Th2 cells and ILC2 cause the immunopathology of asthma including eosinophilia, mast cell activation, goblet cell hyperplasia and fibrosis, which in turn causes airway hyperresponsiveness, bronchoconstriction, tissue remodeling and mucus hypersecretion. However, asthma also occurs in patients devoid of T2 markers. The immunological mechanisms of so called T2 low asthma seems to be related to IL-22/IL-17 cytokines and/or inflammasome activation, but much research remains to unravel the etiology and mechanisms to identify ways of effectively treating T2 low asthma.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078922","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}