Lakartidningen最新文献

{"title":"[Mild intellectual disability in children - some key considerations].","authors":"Elisabeth Fernell, Ida Lindblad, Eva Nordin-Olson, Joachim Sandberg, Anna-Karin Söderström, Eva Tideman, Helka Widengren","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diagnosing mild intellectual disability (ID) in children is very often challenging and may require multiple assessments over time to confirm the diagnosis with confidence. In Sweden, this diagnosis is typically made within the school health services, where close collaboration between psychologists, school doctors, and educators is essential. Children diagnosed with mild ID are entitled to attend specially adapted schools. It is important to recognise that many children with mild ID also experience other developmental, neurological, or neuropsychiatric conditions (ESSENCE). Beyond the initial evaluation in school health services, it is crucial that children be referred to specialised paediatric clinics for further investigation of potential underlying causes. In some cases, a child psychiatry consultation may also be necessary. Given the frequent presence of comorbidities, children with mild ID require ongoing clinical follow-up to support their development over time.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256221","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":"[Peripheral nerve injuries - early diagnosis and appropriate treatment is crucial].","authors":"Lars B Dahlin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ballistic injuries to upper and lower limbs in local and international conflicts are common, where particularly peripheral nerve injuries should be highlighted. Handling of injured and destroyed tissues requires a fast and competent multidisciplinary management of the patient and depends on the extent and character of the injuries. Early experiences from conflicts have shown that peripheral nerve injuries are difficult to treat, often resulting in extensive permanent loss of function, risk for pain problems and life-long reduced quality of life. Early diagnosis, sometimes based on »active surveillance« of the nerve injury, initiation of appropriate surgical techniques from the panel of conventional and novel methods, and pharmacological treatment of nerve injuries are keystones and can improve the situation for the affected patient, where timing of treatment is crucial.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256222","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":"[Gene editing is changing the treatment of hereditary diseases].","authors":"C I Edvard Smith, Rula Zain, Pontus Blomberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Gene editing is a novel technology within gene therapy, which changes sequences in chromosomal DNA with precision. Even if there are alternative strategies, the Nobel Prize-winning CRISPR/Cas technology has become the dominating principle. During recent years base editing and prime editing, permitting editing without DNA double-strand breaks, have been developed. The first clinical gene editing results were reported in 2021; since then many patients have been treated, and recently the first treatment was approved as a novel therapy in the UK and later in USA and in EU. This update describes various aspects including methodological developments and safety.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059783","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":"[AmbuReg - the Swedish quality register for emergency medical services].","authors":"Glenn Larsson, Johan Herlitz, Christer Axelsson, Maria Hegardt Janson, Susanne Albrecht, Håkan Klementsson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Swedish quality register AmbuReg collects all the country's ambulance missions. There is an increasing demand on the Emergency Medical Services (EMS) due to decreasing hospital resources and referral to self-care, primary care and mobile teams. This, in combination with fast tracks for patients with myocardial infarction, stroke, hip fracture or sepsis, increases the requirement for optimal triage at the scene. The aim of the registry is to ensure the quality and identify limitations in the EMS that may threaten patient safety, such as documentation, assessment, triage and treatment. The development of decision support tools will be required in the future and in collaboration with other national quality registries. Regarding adherence to guidelines for assessment and treatment of symptoms, particularly pain, and the use and analysis of equipment such as ECG and analysis of serum glucose, different quality goals may be set. An example may be that at least 80% of strokes should be recognized at the scene.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059780","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":"ABC: Aortagraftinfektioner.","authors":"Hamid Gavali, Kevin Mani, Mia Furebring, Camilla Lorant, Anders Wanhainen","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059740","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":"Cobenfy – ett nytt alternativ för behandling av schizofreni.","authors":"Simon Cervenka","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059816","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":"[Paths to Swedish medical license for international medical graduates].","authors":"Magnus Hultin, Anders Själander, Mimmi Werner, Pernilla Hultberg, Oskar Ragnarsson, Ingmarie Skoglund, Anders Gottsäter, Peter J Svensson, Linda Appelberg, Marie Dahlin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There are four paths to a Swedish medical license. A shared agreement exists for those converting from a European license to recognize qualifications granted in the respective countries mutually. Swedish medical graduates and International Medical Graduates (IMGs) trained outside the EU/EES/Schweiz are assessed against the professional qualifications specified in the Higher Education Ordinance (1993:100). This paper discusses the different pathways to a Swedish Medical License, how they are interrelated and changing, and the number of licenses granted via the specific pathways in 2023 and the previous 7 years. In 2023, 2,318 Swedish medical licenses were awarded. The largest group (1,407/2,318) were graduates from a Swedish medical school (with a minimum of 18 months of internship (AT)). The second largest group (704/2,318) were licensed physicians from a country within the EU/EEA. The smallest group (207/2,318) were international medical graduates (IMGs) who had passed the proficiency test (with a 6-month internship) or a complementary medical education (KUL) at one of the Swedish universities (with a minimum of 18 months of internship (AT)). During 2016-2023, 826 IMGs passed the proficiency test, and 533 IMGs completed KUL. During the same period, 10,958 students graduated from Swedish medical programmes, and 6,844 medical licenses were approved based on education in the EU/EEC. The pathway for IMGs starts with applying to the National Board of Health and Welfare to be approved for the tests. The theoretical test is a 180-item exam with single-best answers covering the medical field with basic and clinical sciences. After passing the theoretical test, the practical skills are tested with an Objective Structured Clinical Examination (OSCE) with fourteen 6-minute and four 14-minute stations. After passing the practical test, the IMG is assessed during a 6-month internship and must take an online Swedish law course. When successfully passing these steps, the IMG applies for a Swedish medical license with a certificate of passing a language test in Swedish at the C1 level. The educational pathway consists of a 1- to 2-year-long complementary programme for international medical graduates (KUL) offered at five Swedish universities. The regular Swedish medical programmes are in transition from preparing for an internship to preparing to qualify directly for a medical license without an intermediate internship. Consequently, KUL also needs to develop new curricula, preparing for direct qualification for a medical license, from which the first students will most likely graduate in spring 2027.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059794","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":"Vägen är för lång och svår för läkare utbildade i tredje land.","authors":"John Wahren, Jan Östergren","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059818","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":"[Glucokinase activators and imeglimin: New drugs against type 2 diabetes].","authors":"Sarah-Ålivia Mänd, Åke Sjöholm","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Type 2 diabetes (T2D) is increasing relentlessly globally, affecting ever younger patients. Many T2D patients do not attain glycemic target levels, indicating a clear need for novel antihyperglycemic drugs. Ideally, these should not only control glycemia, but also halt or slow the progressive loss of beta cells. Two entirely novel classes of antihyperglycemic agents - glucokinase activators and imeglimin -  were recently approved in Asian markets and will be discussed in this review. These two novel drug classes will be a welcome addition and complement to existing treatments. Time will tell whether these new antihyperglycemic agents will add value to the current treatment paradigms against T2D and provide sustained antihyperglycemic effect, acceptable safety, usefulness in combination therapy, and effects on hard end-points such as cardiovascular disease.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983993","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":"[Management of patients in cardiac arrest in the emergency department].","authors":"Love Lindau Liljekvist, Malin Millberg, Therese Djärv, Eric Dryver","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiac arrest is the most time-sensitive condition that personnel face in the emergency department. Optimal management consists of good quality cardiopulmonary resuscitation, the simultaneous performance of focused investigations to identify potential reversible causes, and the delivery of cause-specific treatments. In order to manage patients with cardiac arrest in an efficient manner, team members need to have clearly defined roles and ready access to required equipment. This article presents the latest guidelines for cardiopulmonary resuscitation of patients with cardiac arrest in the emergency department and specific initial therapies for reversible causes. The article highlights specific aspects of the management of patients with cardiac arrest due to major trauma and accidental hypothermia, as well as cardiac arrest in the setting of advanced pregnancy. The article also provides recommendations regarding role allocation to team members involved in cardiac arrest management.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983995","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}