| 1. |
- Allwood, Jens, 1947, et al.
(författare)
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"Vänta och se versus låtsas inte förstå om du inte gör det!" Om svensk sjukvårdspersonals erfarenheter av kommunikation med utländska läkare.
- 2005
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Ingår i: Aktuellt om Migration. - 1652-7119. ; 2:(finns på internet)
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Tidskriftsartikel (refereegranskat)abstract
- Det är knappt att de hörs, steg av fötter i vita fotriktiga inomhussandaler, mjuka och tassande. Ljusa korridorer, väggar med scheman, plastblommor vid fönster och fina neutrala ”institutionsgardiner.” Dämpade röster, deltagande leenden, automatiska dörrar, breda nog för en sjukhussäng. På akuten – en samling människor med väntande och uppgivna ansiktsuttryck. Nuläget: Långa väntetider, tajta och utmattande scheman för personalen med ett ökat antal sjukskrivningar som följd. Ständiga påminnelser om anstående neddragningar och sjukvårdens brister som förstasidesnyheter. Önskas: Tid och pengar, arbetskraft som orkar, kan och vill, som ser möjligheterna och inte problemen. Något som ökar vår återspegling av det nya mångkulturella samhället i vården och som även passar in i våra personalvisioner och måldokument.
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| 2. |
- Berbyuk, Nataliya, 1978, et al.
(författare)
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How do Non-Swedish Physicians Communicate with their Swedish Patients and Colleagues?
- 2006
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Ingår i: Dahl, Ø., Jensen, I., Nynäs, P. (ed.). Bridges of Understanding.. - Oslo : Unipub, Oslo Academic Press. - 8274772695 ; , s. 155-170
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Delbro, Dick, et al.
(författare)
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Nuclear expression of mu-opioid receptors in a human mesothelial cell line
- 2009
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Ingår i: Autonomic & Autacoid Pharmacology. - : Wiley. - 1474-8665 .- 1474-8673. ; 29:4, s. 165-170
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Tidskriftsartikel (refereegranskat)abstract
- 1 Possibly acting via mu-opioid receptors (MORs), morphine inhibits the formation ofexperimentally induced postoperative abdominal adhesions in rats. Mesothelial cells mayparticipate in adhesion formation by secreting mediators that interfere negatively withfibrinolysis. Morphine may prevent adhesions by inhibiting the release of pro-adhesionmediators from mesothelial cells. This study aimed to investigate whether human mesothelialcells express MOR-1; if so, such could constitute a site of action for morphine in adhesionprevention.2 Cells from Met-5A, a human mesothelial cell line were seeded and prepared forimmunocytochemistry and Western blotting.3 Immunocytochemistry showed MOR-1 expression in mesothelial cells, predominantly in thenuclei. Western blotting showed two bands (c. 35 and 50 kDa) which correspond to thoseobtained with a control lysate from cells known to express MORs. In addition, we foundMOR-1 expression with nuclear and cytoplasmatic localization in biopsies from humanabdominal adhesions.4 The current findings may suggest that morphine could interact directly with mesothelial cellsvia MOR-1 receptors, and thereby modulate adhesion formation, possibly by interfering withthe release of pro-adhesion factors from these cells
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| 4. |
- Hansson, Jeanette, 1972, et al.
(författare)
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Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients.
- 2009
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Ingår i: The British journal of surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 96:5, s. 473-81
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A trial in selected men suggested that antibiotic therapy could be an alternative to appendicectomy in appendicitis. This study aimed to evaluate antibiotic therapy in unselected men and women with acute appendicitis. METHODS: Consecutive patients were allocated to study (antibiotics) or control (surgery) groups according to date of birth. Study patients received intravenous antibiotics for 24 h and continued at home with oral antibiotics for 10 days. Control patients had a standard appendicectomy. Follow-up at 1 and 12 months was carried out according to intention and per protocol. RESULTS: Study and control patients were comparable at inclusion; 106 (52.5 per cent) of 202 patients allocated to antibiotics completed the treatment and 154 (92.2 per cent) of 167 patients allocated to appendicectomy had surgery. Treatment efficacy was 90.8 per cent for antibiotic therapy and 89.2 per cent for surgery. Recurrent appendicitis occurred in 15 patients (13.9 per cent) after a median of 1 year. A third of recurrences appeared within 10 days and two-thirds between 3 and 16 months after hospital discharge. Minor complications were similar between the groups. Major complications were threefold higher in patients who had an appendicectomy (P < 0.050). CONCLUSION: Antibiotic treatment appears to be a safe first-line therapy in unselected patients with acute appendicitis. Registration number: NCT00469430 (http://www.clinicaltrials.gov).
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| 5. |
- Jansson, Svante, 1948, et al.
(författare)
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Treatment of bilateral pheochromocytoma and adrenal medullary hyperplasia.
- 2006
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Ingår i: Annals of the New York Academy of Sciences. - : Wiley. - 0077-8923. ; 1073, s. 429-35
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Tidskriftsartikel (refereegranskat)abstract
- The risk for bilateral tumors and long-term outcome after conservative cortical-sparing adrenal surgery was studied in a consecutive single-center series. One hundred fifty-four patients were operated on (1950-2004) for pheochromocytoma (PC=137), or abdominal paraganglioma (PG=17). Twenty had MEN 2 (16 MEN 2A; 4 MEN 2B), 15 von Recklinghausen's disease (VRD), and 1 von Hippel-Lindau (VHL) disease. Twelve patients had, or developed, bilateral adrenal medullary tumors; four with MEN 2A, four with MEN 2B, three with VRD, and one with probably hereditary PC associated with brain tumors/meningioma. Two patients with MEN 2B and one with MEN 2A with had bilateral adrenalectomy (adx). Three VRD patients, two MEN 2B and one MEN 2A patients had cortical-sparing surgery. Two patients were operated on unilaterally, but developed small contralateral tumors; one of these (MEN 2A) had a second asymptomatic PC diagnosed at an older age, so surgery was withheld; the other patient (hereditary PC syndrome) had a small contralateral PC diagnosed at autopsy 9 years later. Only three of nine patients with bilateral operations needed corticosteroid replacement after surgery. Four of six patients died of associated tumors (MTC and meningioma). The mean follow-up was 13 (1-25) years. Twelve MEN 2A patients with unilateral adx have been followed up for 20 (4-36) years without developing a second PC. Cortical-sparing adrenal surgery can safely be performed in the majority of patients with bilateral PC. On the basis of our long-term experience of MEN 2A we perform contralateral adrenal resection only if a second PC is confirmed. Five patients underwent adrenal exploration because of clinical and biochemical findings compatible with PC. Four had asymmetrical positive MIBG scans. They all underwent unilateral adx and diffuse medullary hyperplasia was confirmed (medullary weight estimated morphometrically to 1.0-3.4 g vs. normal weight 0.3-0.5 g in matched controls). These patients have been followed for 19 (5-27) years with normal clinical and biochemical findings. In this rare condition removal of the largest adrenal seems adequate.
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| 6. |
- Khorram-Manesh, Amir, 1958, et al.
(författare)
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Hospital-related incidents; causes and its impact on disaster preparedness and prehospital organisations.
- 2009
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Ingår i: Scandinavian journal of trauma, resuscitation and emergency medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: A hospital's capacity and preparedness is one of the important parts of disaster planning. Hospital-related incidents, a new phenomenon in Swedish healthcare, may lead to ambulance diversions, increased waiting time at emergency departments and treatment delay along with deterioration of disaster management and surge capacity. We aimed to identify the causes and impacts of hospital-related incidents in Region Västra Götaland (western region of Sweden). METHODS: The regional registry at the Prehospital and Disaster Medicine Center was reviewed (2006-2008). The number of hospital-related incidents and its causes were analyzed. RESULTS: There were an increasing number of hospital-related incidents mainly caused by emergency department's overcrowdings, the lack of beds at ordinary wards and/or intensive care units and technical problems at the radiology departments. These incidents resulted in ambulance diversions and reduced the prehospital capacity as well as endangering the patient safety. CONCLUSION: Besides emergency department overcrowdings, ambulance diversions, endangering patient s safety and increasing risk for in-hospital mortality, hospital-related incidents reduces and limits the regional preparedness by minimizing the surge capacity. In order to prevent a future irreversible disaster, this problem should be avoided and addressed properly by further regional studies.
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| 7. |
- Khorram-Manesh, Amir, 1958, et al.
(författare)
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Long-term outcome of a large series of patients surgically treated for pheochromocytoma
- 2005
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Ingår i: Journal of internal medicine. - 0954-6820. ; 258:1, s. 55-66
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To analyse the morbidity, mortality and long-term outcome in a consecutive series of surgically treated patients with pheochromocytoma (PC), or paraganglioma (PG), from the western region of Sweden between 1950 and 1997. PATIENTS: All patients (n = 121) who had been hospitalized and treated for PC/PG over 47 years. DESIGN: Retrospective review of patients with PC/PG regarding presenting symptoms, tumour characteristics, clinical management and long-term outcome after treatment. SETTING: One referral centre for all patients from the western region of Sweden. RESULTS: During an observation of 15 +/- 6 years, 42 patients died vs. 23.6 expected in the general population (P < 0.001). There was no intra- or post-operative mortality. Four patients with sporadic disease died of malignant PC and six with hereditary disease of associated neuroectodermal tumours. Five patients died of other malignancies, 20 of cardiovascular disease and seven of other causes. Besides older age at primary surgery, elevated urinary excretion of methoxy-catecholamines was the only observed risk factor for death (P = 0.02). At diagnosis 85% of the patients were hypertensive; one year after surgery more than half were still hypertensive. However, pre- and post-operative hypertension did not influence the risk for death versus controls. CONCLUSION: Pheochromocytoma/PG can be safely treated by surgery. Death of malignant PC/PG was unusual, but the patients as a group had an increased risk of death. We recommend life-long follow-up of patients treated for PC/PG with screening for recurrent tumour in sporadic cases and for associated tumours in hereditary cases. This strategy would also be helpful in diagnosing cardiovascular disease at an early stage.
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| 8. |
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| 9. |
- Khorram-Manesh, Amir, 1958, et al.
(författare)
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Management of traumatic liver injuries without a valid trauma system.
- 2009
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Ingår i: Prehospital and disaster medicine. - 1049-023X. ; 24:4, s. 349-55
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Despite a global increase in conservative treatment of blunt liver injuries, the number of surgically treated traumas in one major trauma center in Iran has increased. The aim of this study was to unveil the reasons behind this increase in operative management by studying 228 consecutive patients at this regional center. HYPOTHESIS: The increased number of liver injuries operated upon is due to the lack of a solid, well-defined trauma system. METHODS: A retrospective review of all patients admitted for liver trauma at Bahonar Hospital, Kerman, Iran, from March 2001 until March 2006 was conducted. Patient data were collected, studied and statistically processed with regard to demographics, clinical and laboratory findings, surgical procedures, complications, and mortality. RESULTS: All patients who were admitted between 30-360 minutes after injury were included. Twelve hemodynamically stable patients were treated conservatively in an ordinary surgical ward. The remaining 216 patients, 153 of whom had blunt injuries, were hemodynamically unstable. A total of 70 patients were in hemorrhagic shock at the time of arrival. Hemodynamically unstable patients with either the suspicion of associated injuries and/or who displayed clinical deterioration and could not be observed in an ordinary surgical ward were treated surgically. The majority of patients who were operated upon in this series had a grade-II liver injury. The total mortality rate in surgically treated patients was 18.1%. None of the patients treated conservatively died. CONCLUSIONS: Despite the low grade of their liver injuries, the high number of surgically treated patients in this series was due to the absence of a valid trauma system. This result should encourage the authorities to review current trauma systems and trauma surgical guidelines.
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| 10. |
- Khorram-Manesh, Amir, 1958, et al.
(författare)
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Mortality associated with pheochromocytoma: increased risk for additional tumors.
- 2006
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Ingår i: Annals of the New York Academy of Sciences. - : Wiley. - 0077-8923. ; 1073, s. 444-8
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Tidskriftsartikel (refereegranskat)abstract
- A consecutive series of patients (68 females and 53 males) with pheochromocytoma (PC, n=110) or paraganglioma (PG, n=11) were treated at the Sahlgrenska University Hospital (1950-1997). During the observation period (15+/-6 years) 42 patients died versus 23.6 expected in the general population (P<0.001). There was no surgical mortality. Twenty patients died of cardiovascular disease, 11 of other tumors, and 7 of other diseases, but only 4 of PC/PG. The main causes of death in this regional series were cardiovascular diseases and tumor in a ratio of 1.3 versus 2.0 in the general Swedish population. Analysis of the mortality in all patients with clinically diagnosed PC (n=481, 259 women and 222 men) based on the National Cancer Registry (1957-1997) showed that the number of deaths in this cohort was 196 versus 153.4 expected (P<0.001). These patients had almost four times higher risk of dying of a tumor than did the general population (similar risk for females and males). There was no increased risk for cardiovascular death; in fact, the risk was lower than expected for men (22 vs. 38 expected). A second tumor diagnosed subsequent to PC occurred in 68 versus 31 expected. In men tumors of the liver and biliary tract and central nervous system and in women malignant melanoma and cervix carcinoma were most frequent. The results from the national series thus confirm an increased risk of a second tumor and increased tumor-related mortality in patients with PC.
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