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Cartesiansk dualism i ohälsans otjänst – nytt steg efterlyses. 笛卡尔二元论为不良健康服务--需要迈出新的一步。
Lakartidningen Pub Date : 2024-03-27
Mats Lekander, Lisbeth Sachs, Simon Cervenka
{"title":"Cartesiansk dualism i ohälsans otjänst – nytt steg efterlyses.","authors":"Mats Lekander, Lisbeth Sachs, Simon Cervenka","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293915","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
[Circulatory failure after bupropion overdose]. [过量服用安非他明后出现循环衰竭]。
Lakartidningen Pub Date : 2024-03-26
Erik Norberg, Kai Knudsen, Andreas Blomgren, Marc Stevens, Erik Lindeman, Johanna Nordmark Grass
{"title":"[Circulatory failure after bupropion overdose].","authors":"Erik Norberg, Kai Knudsen, Andreas Blomgren, Marc Stevens, Erik Lindeman, Johanna Nordmark Grass","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A case of massive overdose of sustained release bupropion tablets is described. The patient presented with GCS 3, tachycardic and in vasoplegic shock. ECHO and EKG were initially normal. The hemodynamic situation was stabilised with vasopressors, but 18 h after presentation the patient deteriorated with wide complex arrhythmias rapidly progressing to cardiac arrest. The patient was put on VA-ECMO after 35 minutes of CPR. Circulation could be stabilized and ECMO was discontinued after 36 h. The patient was extubated on day 6 and made a complete recovery on discharge two weeks after presentation. At 34h, with ongoing ECMO, 236 tablets (with visible print identifying them as bupropion) were evacuated from the patient's stomach by gastroscopy. The tablets were analysed by NMR (nuclear magnetic resonance) but no longer contained any active substance. Blood levels of bupropion and hydroxybupropion at 36h were 790 and 1300 µg/l. The case illustrates a worrying surge in serious bupropion poisonings as noted by the Swedish Poisons Information Centre during the last 5 years.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140288468","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
[Management of patients with altered mental status in the Emergency Department]. [急诊科精神状态改变患者的管理]。
Lakartidningen Pub Date : 2024-03-25
Jalal El Ali, Pavel Coufal, Christian Engvall, Åslög Hellström Vogel
{"title":"[Management of patients with altered mental status in the Emergency Department].","authors":"Jalal El Ali, Pavel Coufal, Christian Engvall, Åslög Hellström Vogel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patients who present to the Emergency Department with altered mental status may suffer from serious, time-sensitive conditions where appropriate initial management improves prognosis. The differential diagnoses of altered mental status is broad and the assessment is complicated by the patient's inability to provide a detailed history. This article presents a systematic approach to patients with altered mental status in the Emergency Department. Data from a structured physical examination and bedside tests are interpreted in light of the medical background and available history. A checklist is recommended to consider key time-sensitive conditions. The article covers the emergency treatment of selected time-sensitive conditions and provides guidance for when head CT-scan is warranted.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207193","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
[Review of anesthetic technique and 30-day mortality for cholecystectomies based on the Swedish Perioperative Registry]. [基于瑞典围手术期登记的胆囊切除术麻醉技术和 30 天死亡率回顾]。
Lakartidningen Pub Date : 2024-03-25
Johanna Ly, Johanna Albert, Jan Jakobsson
{"title":"[Review of anesthetic technique and 30-day mortality for cholecystectomies based on the Swedish Perioperative Registry].","authors":"Johanna Ly, Johanna Albert, Jan Jakobsson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Swedish Perioperative Registry (SPOR) offers a unique opportunity for monitoring the peri- and early postoperative processes. It can be utilized for quality monitoring within individual clinics or for epidemiological studies. Combining SPOR's data with organ-specific registries provides a more comprehensive understanding of the overall peri- and early postoperative care and outcomes of surgical procedures. In our example, we present the expected patient profile for gall bladder surgery in Sweden. Inhalation anesthesia is the dominant technique, but Total Intravenous Anesthesia (TIVA) is showing an increasing trend in usage. There are minimal differences between the techniques in terms of early complications, with a mere 8-minute variation in recovery time. The mortality rate for cholecystectomy in Sweden is reassuringly low, with 0.02% of patients passing away within 24 hours and a 30-day mortality rate of 0.13%. As expected, advancing age and higher ASA class increase the risk of mortality within 30 days. Additionally, there is a clear area for improvement identified in increasing the utilization of LÖF's Safe Surgery Checklist.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207194","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
[Diabetes and periodontitis - common, important but often neglected]. [糖尿病和牙周炎--常见、重要但常被忽视]。
Lakartidningen Pub Date : 2024-03-13
Anna Norhammar, Anders Gustafsson, Lars Rydén, Kerstin Brismar
{"title":"[Diabetes and periodontitis - common, important but often neglected].","authors":"Anna Norhammar, Anders Gustafsson, Lars Rydén, Kerstin Brismar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diabetes and periodontitis are two global epidemics. There is a two-way relationship between diabetes and periodontitis. Diabetes increases the risk of periodontitis and periodontitis increases the risk for deteriorating glucose levels, having undetected diabetes, and for future diabetes. A recent Cochrane report summarized that there is moderate-certainty evidence that periodontal treatment improves glycaemic control in people with both periodontitis and diabetes. The recent PAROKRANK study found that undetected dysglycaemia was independently associated to both myocardial infarction and to periodontitis. To increase awareness of oral health in people with diabetes this article summarizes recent evidence.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140110625","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
[Periodontitis - an often neglected risk factor for several other diseases]. [牙周炎--其他几种疾病经常被忽视的风险因素]。
Lakartidningen Pub Date : 2024-03-13
Anders Gustafsson, Anna Norhammar, Björn Klinge, Lars Rydén
{"title":"[Periodontitis - an often neglected risk factor for several other diseases].","authors":"Anders Gustafsson, Anna Norhammar, Björn Klinge, Lars Rydén","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Periodontitis is a chronic inflammatory disease that degrades dental supporting tissues, including the alveolar bone. The global prevalence is 19%, in Sweden it is 11%. Left untreated, periodontitis can cause loss of teeth. The initial clinical manifestations of periodontitis usually start between 35 and 45 years of age. The underlying pathological mechanism is an aberrant inflammatory response to the bacteria colonizing the gingival crevice. Periodontitis has been associated with several other diseases, most prominently diabetes. The relation between periodontitis and diabetes is bidirectional in the sense that diabetes increases the risk for periodontitis and vice versa. Periodontitis also increases the risk for cardiovascular disease and cancer.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140110553","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
[Adverse drug reactions in the oral cavity]. [口腔中的药物不良反应]。
Lakartidningen Pub Date : 2024-03-12
Ylva Böttiger, Emma Ekenstråle
{"title":"[Adverse drug reactions in the oral cavity].","authors":"Ylva Böttiger, Emma Ekenstråle","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Adverse drug reactions commonly occur in the oral cavity, and although these reactions are seldom life threatening, they may severely affect quality of life, as well as the nutritional status of the patient. Hyposalivation is often caused by antidepressants, antihistamines, and diuretics, and the risk increases with polypharmacy. A dry mouth may in turn lead to oral candidosis, which may also be caused by treatment with antibiotics, immunosuppressants or corticosteroids. Other possible adverse drug reactions that may be seen in the oral cavity include gingival hyperplasia, ulcerations, allergic mucosal reactions, changes in sensibility or taste, as well as discoloration of saliva and/or the oral mucosa. Drug-induced osteonecrosis of the jaw from bisphosphonates is also mentioned in this context. The risk of many adverse drug reactions in the mouth can be decreased by good oral hygiene, in combination with regular revisions of the patient's drug treatment. However, there is a risk that physicians do not examine the oral cavity, while dentists may not have complete information about the patient's drug treatment. A close collaboration between medical and dental health care is the key to reducing adverse drug reactions in the mouth.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101891","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
[Oral diseases and dementia]. [口腔疾病与痴呆症]。
Lakartidningen Pub Date : 2024-03-12
Kåre Buhlin, Maria Eriksdotter
{"title":"[Oral diseases and dementia].","authors":"Kåre Buhlin, Maria Eriksdotter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aging population makes the increase in cognitive disorders a challenge. One of the risk factors is old age, but also oral diseases, especially periodontitis, have been linked to an increased risk of dementia, especially Alzheimer's disease (AD), although research studies show varying correlations. Dental care utilization also decreases after a dementia diagnosis. The periodontal diseases are inflammatory disorders and common in the adult population. Periodontitis leads to loss of the supporting tissue of the tooth and, if untreated, to loss of teeth. Inflammation also plays a role in AD, the most common form of dementia. The reason for an association could be that periodontitis may lead to a spread of pro-inflammatory mediators and oral microorganisms to the brain. Another explanation suggests that chewing may stimulate nerve impulses and increase the blood flow to the brain. Fewer teeth could lead to less stimulation and reduced blood flow. In conclusion, oral diseases and dementia appear to be associated. Whether this connection constitutes a causal connection is more uncertain.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101893","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
[Dental caries - the most common noncommunicable disease and its impact on general health and disease]. [龋齿--最常见的非传染性疾病及其对总体健康和疾病的影响]。
Lakartidningen Pub Date : 2024-03-12
Marie Nordström, Anders Hedenbjörk-Lager, Gunnel Hänsel Petersson, Dan Ericson
{"title":"[Dental caries - the most common noncommunicable disease and its impact on general health and disease].","authors":"Marie Nordström, Anders Hedenbjörk-Lager, Gunnel Hänsel Petersson, Dan Ericson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>More than 2.8 billion individuals worldwide suffer from untreated caries. Over ninety-five percent of all 50-year-olds in Sweden have caries experience. Caries is the most common cause of dental restorations and tooth loss. Tooth loss is associated with cardiovascular diseases, dementia, and death. Periapical tooth infections caused by caries can spread and cause severe infection, however rarely with lethal outcome. Sugars are a common risk factor for caries and other noncommunicable diseases such as cardiovascular diseases, diabetes, and obesity.  Caries is a consequence of sugar-provoked acid production and dysbiosis in the tooth biofilm (dental plaque). There are several conditions which may increase the risk for dental caries, such as different medical conditions and medications which may cause dry mouth. Treatment costs for caries are high.</p>","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101892","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
Sjukdomar som kan uppstå i den orala slemhinnan. 可能发生在口腔粘膜的疾病。
Lakartidningen Pub Date : 2024-03-11
Palle Holmstrup, Mats Jontell
{"title":"Sjukdomar som kan uppstå i den orala slemhinnan.","authors":"Palle Holmstrup, Mats Jontell","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17988,"journal":{"name":"Lakartidningen","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101894","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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