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PubMed Journal Database | Lakartidningen RSS

11:22 EST 28th January 2020 | BioPortfolio

The US National Library of Medicine and National Institutes of Health manage PubMed.gov which comprises of more than 29 million records, papers, reports for biomedical literature, including MEDLINE, life science and medical journals, articles, reviews, reports and  books.

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For example view all recent relevant publications on Epigenetics and associated publications and clincial trials.

Showing PubMed Articles 1–25 of 404 from Lakartidningen

Myotonic dystrophy type 1 - a rare cause of bradycardia in the young.

Myotonic dystrophy type 1 (Steinert's disease) is a rare but important cause of bradycardia in the young. Syncope is primarily considered to be caused by high-degree atrioventricular block II-III but may also be caused by sinus node dysfunction. Life-threatening ventricular arrhythmias do occur, and in cases with impaired systolic left ventricular function, indication for a primary preventive implantable cardiac defibrillator should be evaluated. All patients with myotonic dystrophy type 1 should undergo cl...

Prevalence of healthcare-associated infections based on Swedish point-prevalence survey compared to usage of the European Center of Disease Prevention and Control (ECDC) definitions.

The purpose was to compare the prevalence of healthcare-associated infections (HAI) in the Swedish point prevalence survey with an assessment using the European Centre of Disease Prevention and Control (ECDC) definitions of HAI. A total of 1247 patients were included from three Swedish hospitals. The prevalence of HAI was higher in the Swedish survey as compared to when using the ECDC definitions. The correspondence between results according to Swedish and ECDC protocols was better in Region Västerbotte...

Synovial sarcoma - a rare and highly malignant, tumor with an ambiguous clinical picture at times.

A characteristic feature of soft tissue sarcomas is the absence of alarm symptoms such as pain or abnormal laboratory findings. We present two patients where the diagnostic difficulties delayed the definitive diagnosis, in one case with lethal outcome. The two patients highlight the difficulties a clinician may encounter with this particular disease. Even though synovial sarcoma represents around 0,1 % of all cancer forms, we recommend a high degree of awareness and - when in doubt - prompt contact with a S...

A human rights-based approach improves the mental health care for migrants.

The increasing number of displaced persons and the high proportion of refugees with traumatic background and psychiatric symptoms affect the mental health care offered. Sweden has been criticized by the United Nations for the unsatisfactory fulfilment of the right to health for migrants. This article on human rights in mental health care practice, with a focus on migrants, describes the right to the enjoyment of the highest attainable standard of physical and mental health and what this right implies for ...

Cultural and social variability need to be included in development of methods.

Psychiatric treatment must be developed and adapted, as Sweden's population has become increasingly multicultural and many migrants are refugees from war and conflict areas. Methods and ways of working need to take account of cultural variation in the expression of symptoms and the fact that many refugees have experienced deeply traumatic events, such as torture and other violations of their human rights. Methods should be sensitive to patients' experiences, knowledge and social situation, and consider soci...

How migration impacts mental health - epidemiological perspectives.

At the end of 2018, almost 1/5th of Sweden's population were migrants (born abroad). Migrants in Sweden, including refugee migrants, have higher risks for psychosis and PTSD, but lower risks for alcohol dependence and suicide than Swedish-born. Regarding depression and anxiety, refugees have a higher risk than other foreign-born people, but it is unclear whether other foreign-born persons are at higher risk than Swedish-born. Asylum seekers and refugees seem particularly vulnerable to poor mental health, an...

During the first years in Sweden migrants utilize less psychiatric care than Swedish born do.

This paper focus on migrants' utilization of psychiatric care, defined here as a contact in primary care due to psychiatric problems, psychiatric in- and outpatient secondary care, voluntary and compulsory use of psychiatric emergency services and compulsory unit admissions. The utilization of psychiatric care among migrants is lower than for the Swedish-born population during the ten first years in Sweden, except compulsory care. The utilization of psychiatric care increases over time among migrants, but t...

Transcultural encounter empowering the vulnerable patient.

The Swedish word, 'bemötande', has no direct equivalent in English but refers to contact, treatment and the relationship with a patient. 'Bemötande', in the context of care, concerns amongst other things how the session is conducted and takes place. The experience of a positive 'bemötande' is important for the patient and relatives to be able to feel trust and confidence, as well as to create a well-functioning working alliance. A respectful 'bemötande' is made more difficult by people's need to classif...

New recommendations for antiepileptic drug therapy: the last piece in the review of epilepsy care.

Antiepileptic drug (AED) therapy is symptomatic. New AED:s have not decreased the proportion of epilepsy patients resistant to pharmacological treatment. Lamotrigine, levetiracetam and carbamazepine are first-line options for focal seizures. Lamotrigine, levetiracetam and valproic acid are first-line options for generalized seizures. However, valproic acid is contraindicated during pregnancy unless there is no other effective treatment available, as well as for fertile girls/women unless the conditions of a...

Evening dosing of antihypertensive drugs - future studies should be awaited before changing clinical practice.

Night-time blood pressure is an independent prognostic marker for cardiovascular disease. Evening dosing of antihypertensive agents can reduce night-time blood pressure and restore night-time blood pressure dipping pattern. In the Hygia Chronotherapy Trial, evening dosing of antihypertensive agents was compared to morning dosing, with dramatic effects on cardiovascular events and total mortality. We review possible limitations of the Hygia trial, including aspects of randomization, allocation concealment, o...

Thoracal actinomycosis - a diagnostic challenge.

Actinomycotic infection of the chest structures is rare but can be serious. Diagnosis is difficult, since both culture of the bacterium and pathological investigation require special methods. Investigations therefore usually take many months before the correct treatment can be started. The most common differential diagnosis is a chest malignancy. Treatment is long-term antibiotics. We here present three cases which illustrate the clinical and radiological findings and the diagnostic difficulties.

Early or delayed cardioversion in atrial fibrillation?

Atrial fibrillation is one of the most common arrhythmias. As the symptoms can be abrupt in onset it is associated with a substantial burden on the medical emergency system. By routine practice patients with symptomatic atrial fibrillation of a duration less than 48 hours are commonly offered cardioversion therapy. Data from a recent study shows that more than two thirds of patients convert to sinus rhythm spontaneously within 48 hours. A watch-and-wait approach in rhythm control management may be suggested...

Hypocomplementemic urticarial vasculitis syndrome: a rare but not always benign condition.

Although more than 45 years have passed since hypocomplementemic urticarial vasculitis (HUVS) was first described by McDuffie and colleagues at the Mayo clinic, data on epidemiology, disease outcomes, prognosis and clinical features are scarce. Recently, we published the first epidemiological study of HUVS including data on incidence, prevalence, disease outcomes, prognosis and clinical features using data from two separate Swedish regions during a period of 16 years. The estimation of incidence and prevale...

The priority-setting platform and its conditions.

The platform for priority-setting contains key ideas about the mission, goals and values of health care in Sweden. The basic idea is that health care resources should be distributed primarily according to need and effect, and secondarily according to cost-effectiveness. Nobody should be discriminated against on the basis of their gender, age, religion, ethnic origin or political views. We also need to distinguish between the health-related needs that we, as a society, have agreed should be met by publicly f...

Care delay the most common error in ophthalmic health care.

This study reviewed 102 decisions on error reports in ophthalmic health care in Sweden between March 2017 and October 2018. The study included children, adults, women and men. We found that there was a clear association between long waiting times for ophthalmic health care and negative visual outcomes. As a result of care delay, 71 percent of the patients had moderate vision loss and 17 percent of the patients experienced severe vision loss. Patients with glaucoma and wet macular degeneration accounted for ...

Neonatal suppurative parotitis.

Neonatal suppurative parotitis is a rare condition characterized by swelling, pain and erythema over the parotid gland. There may be a purulent exsudate from the Stensen duct. The predominant etiology is Staphylococcus aureus but cases with gram negative bacteria and streptococci have been reported. Most cases are managed conservatively with intravenous antibiotic therapy, and early treatment reduces risks of complications like sepsis and intraglandular abscess. We report two cases of neonatal suppurative p...

Argon plasma coagulation effective treatment of solitary rectal ulcer syndrome.

Solitary rectal ulcer syndrome (SRUS) is a rare disorder likely to be caused by a traumatic and ischemic mucosal injury related to latent or overt rectal prolapse. Mucosal damage can vary between erythema and up to intractable ulceration. The typical symptoms of SRUS may resemble those of inflammatory bowel disease (IBD)-related proctitis or rectal malignancy with mucus- and blood-mixed defecation with urgency and sometimes transient incontinence. The purpose of this paper is to raise awareness of this rare...

Occupational exposures should be considered in all patients with non-malignant respiratory diseases.

Occupational exposures to gas, fumes, dust and chemicals contribute to non-malignant respiratory diseases like asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis and community-acquired pneumonia in more than one in ten patients. They may be sick due to inhaling various particles, gases, fumes, or chemicals in the workplace. Hence, these exposures should be considered in all patients with non-malignant respiratory diseases. In an international literature review the occupational burd...

PFAPA syndrome - An important differential diagnosis in children with recurrent fever.

Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis (PFAPA) syndrome is the most common autoinflammatory disorder among children in many parts of the world and an important differential diagnosis in children presenting with recurrent fever episodes. Commonly, PFAPA has an onset under the age of 5 years. Fever episodes in PFAPA usually last 3-6 days and are associated with one or more of the cardinal symptoms aphthous stomatitis, pharyngitis and cervical adenitis. The fever episodes typica...

Analytical investigation of a suspected case of drug-facilitated crime.

Sometimes it is suspected that people have been involuntary exposed to drugs, usually by spiked drinks. A young woman was transported to an emergency department by ambulance. Her clinical symptoms (decreased consciousness, mydriasis, confusion, hallucinations and urine retention) indicated anticholinergic syndrome that was effectively treated with the antidote physostigmine. A urine sample tested negative for common narcotic drugs and alcohol, but an extended toxicological analysis of the urine revealed the...

Intoxication with prilocaine/lidocaine can cause serious methemoglobinemia.

Prilocaine/lidocaine is widely used as local anesthetic in children for cannulation and minor surgical procedures. Usually it is unproblematic but it is important to adhere to recommended dose to avoid serious complications. Excessive amount of prilocaine/lidocaine, large application area, prolonged application time or repeated application can, especially in infants, cause methemoglobinemia with clinical symptoms. In severe cases intensive care and antidote treatment with Methylene blue may be required. ...

Maternal deaths in Sweden: Diagnostics and clinical management could be improved.

MM-ARG, the Swedish maternal maternity mortality group within SFOG (Swedish Society of Obstetrics and Gynecology) has, since 2008, surveyed and analysed maternal deaths in Sweden with the aim to find and give feedback on lessons learned to the medical professions.  MM-ARG consists of obstetricians, midwives and anesthetists and the strength of the working model is that the profession itself takes responsibility for the scrutiny.  A summary of 67 known maternal deaths from 2007‒2017 is presented. Direct ...

Systemic sclerosis - a rare but important diagnosis in primary health care.

Systemic sclerosis is an autoimmune systemic disease with an annual incidence in Sweden of only 20 cases per million and a standardised mortality rate of 3-4. Disease onset is usually preceded by a period with Raynaud's phenomenon, combined with structurally abnormal nailbed capillaries and accompanied by presence of scleroderma related autoantibodies. The presenting symptoms are skin thickness, puffy fingers, digital ulcers, dysphagia, joint stiffness and pain, and pruritus. Optimal management involves a n...


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