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[Glucagonoma - a rare neuroendocrine tumor (NET) that typically originates in the pancreas]. [胰高血糖素瘤--一种罕见的神经内分泌肿瘤（NET），通常起源于胰腺。］
Lakartidningen Pub Date : 2024-08-06
Julie Christiansen, Katarina Lundqvist
{"title":"[Glucagonoma - a rare neuroendocrine tumor (NET) that typically originates in the pancreas].","authors":"Julie Christiansen, Katarina Lundqvist","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>One of the primary indicators of this condition is a painful and migratory dermatitis. Additionally, early signs often include weight loss and diabetes. Patients with glucagonoma commonly first encounter general practitioners or dermatologists. Unfortunately, due to the nonspecific nature of symptoms such as eczema-like dermatitis, weight loss and diabetes, diagnosis is frequently delayed, often by 2-3 years. Consequently, by the time patients are diagnosed, the tumor has usually grown and metastasized, often spreading to the liver. As a result, surgical intervention is often not possible, and treatment options are usually limited to palliative care. However, with early diagnosis of glucagonoma, treatment can be curative. Therefore, it is crucial for medical professionals who initially meet these patients, including dermatologists, general practitioners, endocrinologists, and others, to be aware of this condition to ensure an early diagnosis. By recognizing the signs and symptoms early, doctors can potentially improve patient outcomes and save lives.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893730","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 after cardiac arrest - Swedish Resuscitation Council summarizes the new guidelines]. [心脏骤停后的重症监护--瑞典复苏委员会总结新指南]。
Lakartidningen Pub Date : 2024-08-05
Anna Lybeck, Sten Rubertsson
{"title":"[Intensive care after cardiac arrest - Swedish Resuscitation Council summarizes the new guidelines].","authors":"Anna Lybeck, Sten Rubertsson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In Sweden 1600 patients/year survive cardiac arrest (30-day survival). Post-resuscitation care is complex and aims to stabilize organ function with focus on preventing secondary brain injury. In 2021 The European Resuscitation Council (ERC) and European Society of Intensive Care Medicine (ESICM) published joint guidelines on post-resuscitation care. In this article the Swedish Resuscitation Council summarizes the new guidelines with addition of more recent evidence to guide post-resuscitation care.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889673","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 not overuse doxycycline as prophylaxis for uncomplicated sexually transmitted infections]. [不要过度使用强力霉素作为无并发症性传播感染的预防药物]。
Lakartidningen Pub Date : 2024-08-02
Finn Filén, Jaran Eriksen, Catharina Missailidis
{"title":"[Do not overuse doxycycline as prophylaxis for uncomplicated sexually transmitted infections].","authors":"Finn Filén, Jaran Eriksen, Catharina Missailidis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>STI prophylaxis using doxycycline is discussed internationally for persons at high risk of STIs (Doxy-PEP). Doxy-PEP would probably have limited effect on gonorrhoea due to resistance to tetracyclines. Doxy-PEP may reduce the incidence of chlamydia and syphilis, but would not reduce the number of complicated infections. Further studies are needed on the effects of intermittent antibiotic use on the microbiome or antibiotic resistance in general.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889672","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
[Rectal biopsies in radioproctopathy]. [放射性直肠病的直肠活检]。
Lakartidningen Pub Date : 2024-08-02
Fredrik Liedberg, Gediminas Baseckas, Pamela Buchwald, Marie-Louise Lydrup
{"title":"[Rectal biopsies in radioproctopathy].","authors":"Fredrik Liedberg, Gediminas Baseckas, Pamela Buchwald, Marie-Louise Lydrup","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It is generally recommended to refrain from taking rectal biopsies in radioproctopathy. Herein we describe the clinical characteristics of urorectal fistulas after such biopsies in five patients. Conservative treatment is rarely successful. Diagnostic difficulties and comorbidities limiting the possibilities for radical surgical treatment options (i e pelvic exenteration) for urorectal fistulas are discussed.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889617","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
[Sickle cell disease - common and dangerous complications]. [镰状细胞病--常见和危险的并发症]。
Lakartidningen Pub Date : 2024-07-12
Hedvig Björkman, Marcus Fager Ferrari, Alexandros Arvanitakis, Christian Kjellander
{"title":"[Sickle cell disease - common and dangerous complications].","authors":"Hedvig Björkman, Marcus Fager Ferrari, Alexandros Arvanitakis, Christian Kjellander","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sickle cell disease is a genetic disorder affecting hundreds of thousands of people worldwide. This article will focus on the most common and dangerous acute complications to sickle cell disease. Vaso-occlusive crisis is the most common manifestation of sickle cell disease. Rapid pain relief and treating the underlying cause are cornerstones of the treatment. Acute chest syndrome is the most common cause for intensive care unit admission and death among adult patients with sickle cell disease. The condition is treated as vaso-occlusive crises, but patients often need blood transfusions and respiratory support. Patients with sickle cell disease have an increased risk of stroke. Treatment follows the usual guidelines for stroke with the addition of blood- or exchange transfusions. Splenic sequestration is a rare but acute and life-threatening complication, most commonly seen in children. The condition can quickly lead to hypovolemic shock and the treatment aims to maintain adequate circulation and to treat the underlying cause.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875266","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 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
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