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| 2. |
- Agreus, Lars, et al.
(författare)
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Stor överförskrivning och ökat bruk av protonpumpshämmare : Utbildning och information är en nyckel till att vägleda läkare och allmänhet till rätt användning [Significant over- and misuse of PPIs]
- 2021
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Ingår i: Läkartidningen. - Stockholm, Sweden : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 118
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Tidskriftsartikel (refereegranskat)abstract
- PPIs (Proton-pump inhibitors) offers the best treatment for acid related diseases. The predominant indications for PPI prescription are:GERDeradication of H. pylori-infection in combination with antibioticsH. pylori-negative peptic ulcer healing of and prophylaxis against NSAID/COXIB--induced gastroduodenal lesions acid hypersecretory states such as Zollinger-Ellisons syndrome.The market for PPIs continues to expand in most countries. A significant over- and misuse of PPIs prevails in hospital care as well as in general practice. The predominant reasons for and mechanisms behind the over- and misuse of PPIs are well recognised. The most important consequences of this overprescription of PPIs are increasing medical costs and risk for long-term adverse side effects. Continued education and dedicated information are key factors to guide physicians, medical personnel and patients to adopt to generally accepted principles for and balanced use of PPIs.
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| 3. |
- Ahmed, Abdulla, et al.
(författare)
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Prognostisk riskstratifiering vid pulmonell arteriell hypertension
- 2023
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Ingår i: Lakartidningen. - 0023-7205. ; 120
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Tidskriftsartikel (refereegranskat)abstract
- The 2022 ESC/ERS pulmonary hypertension guidelines recommend multiparametric risk stratification at diagnosis and follow-up to guide treatment in pulmonary arterial hypertension (PAH). The goal is to maintain or achieve a low-risk status, corresponding to a 1-year mortality < 5%. Risk assessment is, however, underutilized in clinical practice, and applied only by 60% of clinicians. To overcome the barrier of underutilization and facilitate risk assessment, we have established a comprehensive internet-based risk stratification calculator (https://www.svefph.se/risk-stratification).
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| 4. |
- Ahmed, Salaheldin, et al.
(författare)
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Andfåddhet potentiellt allvarligt – kräver strukturerad utredning
- 2022
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Ingår i: Lakartidningen. - 0023-7205. ; 119
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Tidskriftsartikel (refereegranskat)abstract
- Dyspnea is a common distressing symptom which may be a sign of a critically threatening condition and has been linked with increased hospitalizations, reduced exercise tolerance and increased mortality. The current neuropsychological model suggests that dyspnea arises due to an imbalance between respiratory drive and achieved ventilation. Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare but detrimental conditions, with high morbidity and mortality, where early diagnosis and treatment initiation significantly improve outcome. These conditions are often accompanied by a diagnostic delay, which for PAH has not improved since the 1980s, underlining the importance of early evaluation and referral to specialists. In the present work, differential diagnoses of dyspnea are discussed along with a proposal on how a structured evaluation should be performed early to minimize the diagnostic delay in PAH and CTEPH and improve outcome.
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| 5. |
- Alfvén, Tobias, et al.
(författare)
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Agenda 2030 och målen för en hållbar utveckling angår oss alla
- 2020
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Ingår i: Läkartidningen. - 0023-7205. ; 117
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Tidskriftsartikel (refereegranskat)abstract
- The 2030 Agenda for Sustainable Development and its seventeen Sustainable Development Goals were adopted by the United Nations General Assembly in 2015. It is a bold agenda for global social, environmental and economic development, with human health as a central theme. Even though substantial improvements in health have been achieved during the last decades, every year over 5 million children die, mostly from preventable causes, and 300 000 women die in conjunction with childbirth. Premature deaths from non-communicable diseases are increasing, and our ability to treat infections is under threat through widespread anti-microbial resistance. Climate change is recognized as the biggest threat to health in our time. When the world now starts to plan for how society and our health systems should be reorganized after the COVID-19 pandemic the 2030 Agenda could and should play a central role. In this context, Agenda 2030 provides an ambitious roadmap for development, with its emphasis on collaboration across borders and disciplines. The agenda is achievable but reaching its goals will require strong commitment at all levels and societal change on a large scale.
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| 6. |
- Alfvén, Tobias, et al.
(författare)
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Agenda 2030 och målen för en hållbar utveckling angår oss alla [The 2030 Agenda for Sustainable Development - an important opportunity to improve global health]
- 2020
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Ingår i: Läkartidningen. - : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 117
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Forskningsöversikt (refereegranskat)abstract
- The 2030 Agenda for Sustainable Development and its seventeen Sustainable Development Goals were adopted by the United Nations General Assembly in 2015. It is a bold agenda for global social, environmental and economic development, with human health as a central theme. Even though substantial improvements in health have been achieved during the last decades, every year over 5 million children die, mostly from preventable causes, and 300 000 women die in conjunction with childbirth. Premature deaths from non-communicable diseases are increasing, and our ability to treat infections is under threat through widespread anti-microbial resistance. Climate change is recognized as the biggest threat to health in our time. When the world now starts to plan for how society and our health systems should be reorganized after the COVID-19 pandemic the 2030 Agenda could and should play a central role. In this context, Agenda 2030 provides an ambitious roadmap for development, with its emphasis on collaboration across borders and disciplines. The agenda is achievable but reaching its goals will require strong commitment at all levels and societal change on a large scale.
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| 7. |
- Alfvén, Tobias, et al.
(författare)
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Mpox hos barn – svenskt perspektiv : Mpox and children - a Swedish perspective
- 2023
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Ingår i: Läkartidningen. - 0023-7205. ; 120
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Mpox (monkeypox) is an infection caused by the monkeypox virus, which belongs to the same family as the smallpox virus. Sporadic infections in humans have been known since the 1970s. Since spring 2022 there has been a global epidemic. The large majority of the mpox cases in the ongoing epidemic have been reported in adult men, the number of infected children is small. The typical manifestation of mpox includes a rash that initially presents as maculopapular lesions and then develops into vesicles and eventually crusts. Transmission of the virus primarily occurs through close contact with infected individuals, particularly through contact with unhealed blisters or wounds, as well as through sexual contacts and exposure to body fluids. In cases of documented close contact with an infected individual, post-exposure prophylaxis is recommended and may also be administered to children whose guardians have contracted mpox.
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| 8. |
- Almén Uvnäs, Ingrid, et al.
(författare)
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Fortsatta brister i ST-läkares utbildning om barn som far illa : »Socialpediatrik, barn som far illa« bör vara ett separat delmål i ST-utbildning i pediatrik
- 2022
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Ingår i: Läkartidningen. - : Läkartidningen Förlag. - 0023-7205 .- 1652-7518. ; 119
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Tidskriftsartikel (refereegranskat)abstract
- Great need of improved training of paediatricians on children at risk of abuseIn 2009 the Swedish Paediatric Society carried out a national survey that examined the training of paediatric specialty registrars concerning child abuse and neglect. The survey was repeated in 2016. Both surveys highlighted considerable deficits. In 2020 a slightly revised version of the original survey was sent to training leads for paediatrics and paediatric surgery in Sweden. The results showed that most paediatric specialty registrars received their clinical training in social paediatrics with actual patients. Most of the clinics cooperated with a Children's Advocacy Centre (»Barnahus« in Swedish) and some were situated in an area with a Child Protection Team. Similar results were obtained for specialty registrars in paediatric surgery. Our survey shows that the training has partly improved and that university hospital clinics perform better than other paediatric clinics. Major educational investments are needed to obtain an equivalent education throughout the country.
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| 9. |
- Almquist, Martin, et al.
(författare)
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Kloka kliniska val – att avstå det som inte gör nytta för patienten : [Choosing Wisely in Sweden]
- 2023
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Ingår i: Läkartidningen. - : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 120
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Forskningsöversikt (refereegranskat)abstract
- Overdiagnosis and overtreatment receive increasing attention. More than 20 percent of health expenditure is without patient benefit, so-called low-value care. Several national and international initiatives have been launched to minimize low-value care. Arguably, the most widely spread initiative is Choosing Wisely. First launched by the American Board of Internal Medicine in 2012, this campaign has spread to more than 20 countries. The Swedish Society of Medicine has identified low-value care as a significant problem in Swedish health care and has established a working group to investigate if and how a campaign based on Choosing Wisely would be feasible in Sweden. Here, the working group reports on the history of Choosing Wisely, identifies potential challenges for deimplementation generally and in the Swedish context specifically.
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| 10. |
- Alsalim, Wathik
(författare)
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Handläggning och behandling av diabetes under ramadan
- 2022
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Ingår i: Lakartidningen. - 0023-7205. ; 119
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Forskningsöversikt (refereegranskat)abstract
- Fasting during the month of Ramadan constitutes one of the five pillars of Islam. Islam is the second largest religion in Sweden. Fasting starts as the sun rises and the latest meal intake (Suhoor) is before the sun rises. The first meal intake (Iftar) is at the end of the fasting period, which is at sunset. Based on epidemiological data it is known that a large proportion of persons with diabetes, both type 1 and type 2, fast for at least fifteen days during Ramadan. However, fasting is not recommended in case of type 1 diabetes or in pregnant women with diabetes, neither in people with type 2 diabetes and multiple complications. Guidelines for the management of diabetes during Ramadan are still limited in Sweden. This review aims to summarize the EASD/ADA guidelines regarding the management of people with diabetes before, during and after Ramadan fasting.
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